American Journal of Bioethics.

Do Patients Want to Participate in Decisions About Their Own Medical Care?

Do patients want to be autonomous? Current legal and bioethical paradigms suggest that they not only want to be, but that they ought to be. It is sometimes difficult to sort out whether autonomy is perceived as a right or as a duty. Patients themselves seem to give a more nuanced answer about their own preferences. For example, Strull and colleagues (1984) surveyed 50 clinicians and 210 patients to ascertain whether patients wanted to participate in decisions about their own treatment. Eighty percent of the patients preferred to have their clinicians make the therapeutic decisions, 19% preferred a shared decision making approach and only a few wanted to make the decision themselves (Strull et al. 1984). Elkin and colleagues (2007) showed that only 44% of patients with a diagnosis of colorectal cancer wanted to be told their prognosis. Bruera and colleagues (2002), Rodriguez and colleagues (2008), and many others, have found similar preferences in many different groups of patients. Robinson and Thomson (2001) summarized this body of research by noting that “patient preferences for involvement in decision making to vary with age, socioeconomic status, illness experience, and the gravity of the decision” (i34). […]

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Volume 15, Issue 10
October 2015