Medical Decision Making: The Family–Doctor–Patient Triad

Aslam, Fawad; Aftab, Omar; Janjua, Naveed Z.

doi:10.1371/journal.pmed.0020129

Cited by 19 publications

(12 citation statements)

References 8 publications

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“…This does not imply that they have relinquished decision-making or accepted an external locus of control, but rather a choice to consider others' opinions and values alongside their own. The importance of family values and participation in medical decision-making can be cultural, such as in mainland China where family decision-making aims to reflect mutual benevolence and the Confucian ideal of family harmony [19] or in Pakistan where decision-making is based on a family-doctor-patient triad norm [20]. Even in Western cultures, arguments for joint patient and family decision-making include respect of the intrinsic community nature of decisionmaking within families and acknowledging that family members have vested interests in patient decisions (e.g.…”

Section: External Valuesmentioning

confidence: 99%

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values

Armstrong

Mullins

2017

Value in Health

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Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. Additionally, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment which could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement. In this commentary, we propose a taxonomy of values underlying patient decisionmaking and provide examples of how these impact provision of healthcare. The taxonomy describes four categories of patient values: global, decisional, situational, and external. Global values are personal values impacting decision-making at a universal level and can include value traits and life priorities. Decisional values are the values traditionally conceptualized in decision making, including considerations such as efficacy, toxicity, quality of life, convenience, and cost. Situational values are values tied to a specific moment in time that modify patients' existing global and decisional values. Finally, discussion of external values acknowledges that many patients consider values other than their own when making decisions. Recognizing the breadth of values impacting patient decision making has implications for both for overall healthcare delivery and for shared decision making, as value assessments focusing only on decisional values may miss important patient considerations. This draft taxonomy highlights different values impacting decision-making and facilitates a more complete value assessment at the point of care.

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Section: External Valuesmentioning

confidence: 99%

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values

Armstrong

Mullins

2017

Value in Health

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“…Future physicians must learn and abide by these principles early in their career. (15)(16)(17)(18)(19) Several studies revealed that medical residents face many ethical challenges, sometimes on a daily basis, in addition to their negative attitudes and low level of knowledge. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29) Therefore, the present study aimed to assess the baseline knowledge, attitudes and practices (KAPs) of medical residents in the Islamic Hospital in Amman (2017) towards healthcare ethics.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitudes and Practices of Medical Residents towards Healthcare Ethics in the Islamic Hospital, Jordan

Abdulrazeq

Al-Maamari

Ameen

et al. 2019

YJMS

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Objective: To assess the baseline knowledge, attitudes and practices of medical residents in the Islamic Hospital in Amman, Jordan towards healthcare ethics.Methods: This was a cross-sectional study conducted among 111 medical residents in the Islamic Hospital in the period from February to April 2017. Data were collected using a self-administered questionnaire, and Pearson's chi-square test was used to test the statistical significance of differences between male and female medical residents at P values <0.05. Results:The majority of the respondent medical residents (76.6%) were aware of the content of the Hippocratic Oath. Ethical dilemmas at some point during clinical practice were reported by 68.0% of medical residents; however, only 6.3% reported encountering such dilemmas on a daily basis. Books, lectures and Media were the most frequent sources used by medical residents for learning about healthcare ethics, while supervisors, chiefs of residents and heads of departments were the most frequently preferred for consultation on both ethical and legal problems. The majority (91%) of respondents showed an interest in learning healthcare ethics. However, gaps in knowledge and negative attitudes were observed. Statistically significant differences between male and female residents were found in the issues related to paternalism in case of disagreement with patients/ families, seeking consent for surgeries but not for tests or medications as well as disclosure of tuberculosis-positive status. Conclusions:There are some gaps in knowledge and negative attitudes towards healthcare ethics among medical residents, where some residents are even unaware of the content of the Hippocratic Oath. Because a substantial proportion of medical residents encounter ethical problems at some point during their clinical practice, there is a necessity to incorporate ethics education into medical curricula, which should be directed at practical real-world dilemmas. Future physicians must learn how to adhere to the four basic principles of healthcare ethics (autonomy, beneficence, justice and nonmaleficence) early in their career.

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“…76 Hardwig 77 posits that, while proxy decision makers must guard against undue emphasis on their own interests, undue emphasis on patients' interests should also be avoided, which requires the 'whole story' of a patients' health. 78 Argue that issues of privacy in shared decision making are rarely a concern in non western countries, as patient-doctor triads are the norm for all consultations.…”

Section: Law Policy and Regulationmentioning

confidence: 99%

Developing a Taxonomy and Mapping Concepts of Shared Decision Making to Improve Clinicians Understanding

Ervin¹

2017

NCOAJ

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Medical Decision Making: The Family–Doctor–Patient Triad

Cited by 19 publications

References 8 publications

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values

Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values

Knowledge, Attitudes and Practices of Medical Residents towards Healthcare Ethics in the Islamic Hospital, Jordan

Developing a Taxonomy and Mapping Concepts of Shared Decision Making to Improve Clinicians Understanding

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