How many times should you call a patient?
Tags: ethics
A gp tries to call a patient who booked a telephone appointment. The GP tries three times. How many times should the GP try to call the patient? What is the right thing to do?
Evaluating the case against medical ethics values
Autonomy: The patient has the right to choose whether or not to answer the GP's call. Trying to call the patient three times could be seen as infringing on their autonomy.
Beneficence: The GP has a duty to act in the patient's best interests. Trying to call the patient three times could be seen as beneficent, as the GP may be trying to reach the patient to discuss important medical matters.
Non-maleficence: The GP has a duty to avoid harming the patient. Trying to call the patient three times could be seen as harmful, as it could be disruptive or annoying to the patient.
Equity: The GP has a duty to treat all patients fairly. Trying to call the patient three times could be seen as unfair, as it could give the patient the impression that their time is not as important as the GP's time.
Evaluating the case against approaches to ethical decision-making
Duty-based ethics (deontology): Deontology is an approach to ethics that focuses on the importance of following rules and duties. From a deontological perspective, the GP has a duty to try to reach the patient, as this is in the patient's best interests. However, the GP also has a duty to respect the patient's autonomy. If the patient has specifically requested not to be called multiple times, then the GP may be violating this duty by calling them three times.
Consequence-based ethics (utilitarianism, consequentialism): Utilitarianism is an approach to ethics that focuses on the importance of maximizing good consequences and minimizing bad consequences. From a utilitarian perspective, the GP should try to call the patient three times if there is a good chance that they will be able to reach the patient and discuss important medical matters. However, if there is a good chance that the patient will not answer the call or that the call will be disruptive, then the GP may be better off not calling them three times.
Logical positivism: Logical positivism is an approach to ethics that focuses on the importance of using logic and reason to make ethical decisions. From a logical positivist perspective, the GP should try to gather all of the relevant information about the situation, such as the patient's medical condition, the patient's preferences, and the likelihood that the patient will answer the call. Once the GP has gathered all of this information, they can then use logic and reason to decide whether or not to call the patient three times.
Options for the case and recommendation
Option 1: The GP calls the patient three times. This is the most direct option, but it also has the potential to infringe on the patient's autonomy and be disruptive.
Option 2: The GP calls the patient twice and then leaves a voicemail message. This option is less likely to infringe on the patient's autonomy or be disruptive, but it also has the potential to delay the patient's care if they do not listen to the voicemail message.
Option 3: The GP calls the patient once and then sends a text message or email. This option is the least disruptive, but it also has the potential to delay the patient's care if they do not check their text messages or email regularly.
The GP should also consider the following factors when deciding whether or not to call the patient three times:
The patient's medical condition: If the patient has a serious medical condition, then the GP may be more likely to call them three times.
The patient's preferences: If the patient has specifically requested not to be called multiple times, then the GP should respect their wishes.
The likelihood that the patient will answer the call: If the GP has a good reason to believe that the patient is unlikely to answer the call, then they may be less likely to call them three times.
The GP should also document their decision-making process in the patient's medical record. This documentation will help to ensure that the GP's decision is transparent and accountable.