2010
DOI: 10.1111/j.1748-720x.2010.00469.x
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Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice

Abstract: Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practic… Show more

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Cited by 101 publications
(114 citation statements)
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“…10 The term SDM is often used inconsistently. 11,12 The following elements characterize our understanding of SDM [13][14][15][16][17][18] : SDM may (and should) be employed in life-threatening disease, where biomedical factors far outweigh placebo effects in determining the outcome. Nevertheless, physicians frequently encounter treatment decisions involving chronic and self-limited illnesses.…”
Section: Introductionmentioning
confidence: 99%
“…10 The term SDM is often used inconsistently. 11,12 The following elements characterize our understanding of SDM [13][14][15][16][17][18] : SDM may (and should) be employed in life-threatening disease, where biomedical factors far outweigh placebo effects in determining the outcome. Nevertheless, physicians frequently encounter treatment decisions involving chronic and self-limited illnesses.…”
Section: Introductionmentioning
confidence: 99%
“…Unfortunately, many encounters of this type take place with specialists who might not know the patient or her parents all that well and hence may be unable to effectively argue against parents' refusal to permit the child to participate in discussions about medical care. Nevertheless, it is widely understood and accepted that the preferred model for effective and ethically justifiable medical decision making for both adults and children is one that embraces shared responsibility, involving the parents and child (to the extent she can or wishes to be involved) in a twoway conversation, which can be challenging at times given the differences in family dynamics, the emotional tension of the situation, and so on [7,12,13].…”
Section: Making Decisions For Childrenmentioning
confidence: 99%
“…En este sentido, y considerando las peculiaridades cognitivas y volitivas de este tipo de pacientes, se ha primado un modelo de decisión compartida en el que paciente y médico sean co-responsables de la misma sobre un modelo autonomista de elección o consentimiento informados (10,61,67). Se sabe que la toma de decisiones en los pacientes psiquiátricos puede verse afectada por una capacidad alterada.…”
Section: J M Villagrán I Lara F González-saizunclassified