Ethical Issues in Using Behavior Contracts to Manage the “Difficult” Patient and Family
- 30 September 2021
- journal article
- research article
- Published by Taylor & Francis Ltd in American Journal of Bioethics
- Vol. 23 (1), 50-60
- https://doi.org/10.1080/15265161.2021.1974974
Abstract
Long used as a tool for medical compliance and adhering to treatment plans, behavior contracts have made their way into the in-patient healthcare setting as a way to manage the “difficult” patient and family. The use of this tool is even being adopted by healthcare ethics consultants (HECs) in US hospitals as part of their work in navigating conflict at the bedside. Anecdotal evidence of their increasing popularity among clinical ethicists, for example, can be found at professional bioethics meetings and conversations and idea-sharing among practitioners on HEC social media. While there are a handful of papers gesturing toward a bioethical critique of behavior contracts of various types, the use of behavior contracts in the context of interpersonal conflict has not been vetted by bioethicists to determine their ethical legitimacy or efficacy. In this paper, we highlight a set of ethical concerns that we believe must be addressed before continuing or widespread implementation of behavior contracts to manage the “difficult” patient or family.Keywords
This publication has 57 references indexed in Scilit:
- Eliminating Visiting Hour Restrictions in HospitalsJournal for Healthcare Quality, 2014
- What's trust got to do with it? Revisiting opioid contractsJournal of Medical Ethics, 2013
- Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled TrialAmerican Journal of Transplantation, 2013
- Communication skills training for healthcare professionals working with people who have cancerEmergencias, 2013
- Power and control: contracts and the patient-physician relationshipInternational Journal of Clinical Practice, 2011
- A randomized trial of contingency management for adolescent marijuana abuse and dependenceDrug and Alcohol Dependence, 2009
- Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-MakingPediatric Clinics of North America, 2007
- Long-Term Opioid Contract Use for Chronic Pain Management in Primary Care Practice. A Five Year ExperienceJournal of General Internal Medicine, 2007
- Family centred care: a review of qualitative studiesJournal of Clinical Nursing, 2006
- The development of performances in autistic children in an automatically controlled environmentJournal of Chronic Diseases, 1961