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Family Caregivers, Patients and Physicians: Ethical Guidance to Optimize Relationships

  • Health Policy
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Abstract

Family caregivers play a major role in maximizing the health and quality of life of more than 30 million individuals with acute and chronic illness. Patients depend on family caregivers for assistance with daily activities, managing complex care, navigating the health care system, and communicating with health care professionals. Physical, emotional and financial stress may increase caregiver vulnerability to injury and illness. Geographically distant family caregivers and health professionals in the role of family caregivers may suffer additional burdens. Physician recognition of the value of the caregiver role may contribute to a positive caregiving experience and decrease rates of patient hospitalization and institutionalization. However, physicians may face ethical challenges in partnering with patients and family caregivers while preserving the primacy of the patient-physician relationship. The American College of Physicians in conjunction with ten other professional societies offers ethical guidance to physicians in developing mutually supportive patient–physician–caregiver relationships.

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Acknowledgement

The ACP Ethics, Professionalism and Human Rights Committee would like to thank and acknowledge the following reviewers of this position paper who provided valuable insights and suggestions: Robert M. Arnold, MD, FACP; David J. Casarett, MD, MA; Lynn Friss Feinberg, MSW; Richard W. Honsinger, Jr, MD MACP; Carol Levine, MA; Solomon Liao, MD; Rhonda Richards; Linda Saunders; Melvyn L. Sterling, MD, FACP; and Brenda Sulick, Ph.D.

Conflict of Interest

Cathy Leffler receives royalties from Springer Publishing for: Leffler, C. Patient and medical education on complementary and alternative care: sorting it all out. In Snyder L ed. Complementary and Alternative Medicine: Ethics, the Patient and the Physician. Totowa, NJ: Humana Press Inc. 2007. Dr. Hood receives grant funding for Best Practices in Managing Hypertension Learning Collaborative, American Medical Group Association with support from Daiichi Sankyo. No other conflicts of interest were disclosed.

Author information

Authors and Affiliations

  1. Center for Ethics and Professionalism, American College of Physicians, 190 North Independence Mall West, Philadelphia, PA, 19106-1572, USA

    Sheryl Mitnick RN, MPH

  2. Ethics, Professionalism and Human Rights Committee, American College of Physicians, Philadelphia, PA, USA

    Virginia L. Hood MBBS, MPH, FACP

  3. Nephrology Unit Rehabilitation, University of Vermont, Burlington, VT, USA

    Virginia L. Hood MBBS, MPH, FACP

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  1. Sheryl Mitnick RN, MPH
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for the American College of Physicians Ethics, Professionalism and Human Rights Committee

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Correspondence to Sheryl Mitnick RN, MPH.

Additional information

This paper, written by Sheryl Mitnick, MPH, RN, Cathy Leffler, JD, and Virginia L. Hood, MBBS, MPH, FACP, was developed by the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee. Members of the Committee were Virginia L. Hood, MBBS, MPH, FACP (Chair); Joseph J. Fins, MD, FACP (Vice Chair); Clarence H. Braddock, III, MD, MPH; Neil J. Farber, MD, FACP; Thomas H. Gallagher, MD, FACP; Richard A. Hranac, MD, FACP; Diane E. Meier, MD, FACP; Aliza Monroe-Wise, MSc; Alejandro Moreno, MD, FACP; Paul S. Mueller, MD, MPH, FACP; Richard L. Neubauer, MD, FACP; Shakaib U. Rehman, MBBS, FACP; Mahmoud Sharaf, MD; Mehdi C. Shelhamer, DO; Barbara J. Turner, MD, FACP; and Frederick E. Turton, MD, FACP. The paper was approved by the ACP Board of Regents on July 13, 2008. The paper has also been endorsed by the Society of General Internal Medicine, the American Academy of Neurology, the American Academy of Hospice and Palliative Medicine, the American College of Chest Physicians, the American College of Osteopathic Internists, the American Geriatrics Society, the American Medical Directors Association, the American Thoracic Society, the Society of Critical Care Medicine and The Endocrine Society.

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Mitnick, S., Leffler, C., Hood, V.L. et al. Family Caregivers, Patients and Physicians: Ethical Guidance to Optimize Relationships. J GEN INTERN MED 25, 255–260 (2010). https://doi.org/10.1007/s11606-009-1206-3

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