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Bioethics memory aid can help assess patient decision-making capacity in medical emergencies
Date:2/5/2010

Physicians in training and bioethicists at Johns Hopkins have created an easy-to-remember checklist to help medical students and clinicians quickly assess a patient's decision-making capacity in an emergency.

A report on the acronym CURVES, and how to use it, will be published in the February issue of Chest. CURVES stands for Choose and Communicate, Understand, Reason, Value, Emergency and Surrogate. Doctors and students easily memorize mnemonic devices, and applying this one will help them determine whether a patient is able to make decisions in emergency situations fraught with stress and uncertainty.

The memory aid is designed to uphold the core bioethical principles of patient autonomy and assurance of benefit, says Joseph Carrese, M.D., director of the Program on Ethics in Clinical Practice at the Johns Hopkins Berman Institute of Bioethics.

The gold standard, he said, is to inform the patient about treatment options, make recommendations when appropriate, and have the patient exercise free will in making treatment choices. But in life-or-death situations, because of severe pain or the illness itself, determining whether a patient has the capacity to engage in such decision-making can be extremely difficult.

Carrese, a co-author of the paper, said the acronym is easy to learn and should help physicians render a clinical judgment about decision-making capacity during a critical event quicker than with assessment methods used for non-emergency situations. The evaluation device should also help practitioners with documenting emergency-medical decisions.

"If you ask medical students, they can rattle off several dozen mnemonics that they've learned to help remember things and organize their thinking," said Carrese, an associate professor at the Johns Hopkins School of Medicine. "Because it can be remembered and recalled under time pressure, then all the key elements are more likely to be considered and appli
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Contact: Michael Pena
mpena@jhsph.edu
410-625-7872
Johns Hopkins Medical Institutions
Source:Eurekalert

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