This ethical vignette discusses guidelines related to residents working in an EDX laboratory, including: direct supervision by a physician, as defined by Medicare, is the minimum standard recommended for all NCS testing; EDX evaluations should be performed by a physician -- specifically a neurologist or physiatrist -- who has had special training in the diagnosis and treatment of neuromuscular diseases; and physicians in a residency or fellowship program require close supervision during the actual testing.

EDUCATIONAL OBJECTIVES: 

Participants will acquire the skills to: 1) Describe when the patient’s autonomy supersedes the physician’s recommendations.  2) Explain the concepts of determining a patient’s “competence.”  3) Review the use of informed consent and the priority order for decisionmaking when an advanced directive is not in place.

ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

DISCLOSURE INFORMATION
 All  authors and planners of this activity had nothing to disclose.

CREDIT DESIGNATION
The AANEM designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

AANEM Ethics Committee