TY  - JOUR
T1  - Who May Challenge a Clinically Accepted Decision? A Procedural Justice Framework for Patient-Initiated Ethics Consultation, Independent Review, and Accessible Clinical Appeals
A1  - Laura Fitzgerald
A1  - Thomas Andersen
A1  - Grace Okafor
A1  - Martin Jensen
JF  - Asian Journal of Ethics in Health and Medicine
JO  - Asian J Ethics Health Med
SN  - 3108-5059
Y1  - 2026
VL  - 6
IS  - 2
DO  - 10.51847/IyOi2kiaWJ
SP  - 76
EP  - 85
N2  - A clinically accepted decision may remain ethically contestable even when it reflects competent professional judgment and ordinary standards of care. The unresolved question is whether patients can trigger a credible process through which disagreement is heard, independently reconsidered when necessary, and connected to an institution capable of giving reasons or providing remedy. This article develops a Decision-Rights / Procedural Justice Architecture for patient-initiated challenge. It distinguishes the right to trigger scrutiny from authority to make, review, uphold, revise, or overturn a clinical decision. Evidence on ethics consultation, rapid review, complaints, patient-safety participation, communication, and ethics-service design indicates that pathway availability alone is insufficient. Meaningful procedural justice requires accessible initiation, intelligible routing, epistemic standing, timely and reasoned response, appropriate independence, defined review authority, and a route to remedy. Ethics consultation, independent review, and clinical appeal therefore perform different institutional functions. A patient may justifiably possess a broad right to initiate challenge without receiving unilateral decisional control, provided that the institutional response is accessible, appropriately independent, reason-giving, timely, and capable of acting on the concern.
UR  - https://smerpub.com/article/who-may-challenge-a-clinically-accepted-decision-a-procedural-justice-framework-for-patient-initiat-z4pqnutjluixron
ER  -