Patient autonomy: Imperfect, Insufficient, but Still Quite Necessary

Journal of Clinical Ethics

Volumn 13, Issue 1, 2002, Pages 57-62

  Ross, Lainie Friedman ^a,b  

^a Department of Pediatrics ^*  (United States)

^b UNIVERSITY OF CHICAGO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST OF ILLNESS; DECISION MAKING; DOCTOR PATIENT RELATION; ETHICS; ETHNOLOGY; HUMAN; INSURANCE; LITERATURE; MEDICAL ETHICS; PATERNALISM; PATIENT CARE; PATIENT PARTICIPATION; PATIENT SATISFACTION; PERSONAL AUTONOMY; PRACTICE GUIDELINE; PROFESSIONAL PATIENT RELATIONSHIP; PSYCHOLOGICAL ASPECT; SOCIAL CLASS; UNITED STATES;

PROFESSIONAL PATIENT RELATIONSHIP;

ANECDOTES; COST OF ILLNESS; DECISION MAKING; ETHICS, CLINICAL; HUMANS; INSURANCE COVERAGE; PATERNALISM; PATIENT PARTICIPATION; PATIENT SATISFACTION; PATIENT-CENTERED CARE; PERSONAL AUTONOMY; PHYSICIAN-PATIENT RELATIONS; PRACTICE GUIDELINES; SOCIAL CLASS; UNITED STATES;

EID: 0036491450     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (19)

1. C.E. Schneider, The Practice of Autonomy: Patients, Doctors and Medical Decisions (New York: Oxford University Press, 1998). Hereafter page references to this book will be included in the text.
2. Annette Dula was a Fellow at the MacLean Center for Clinical Medical Ethics, University of Chicago in 1990-1991. She coedited with Sara Goering a book entitled, "It Just Ain't Fair": The Ethics of Health Care for African Americans (Westport, Conn.: Praeger, 1994).
3. Dateline, August 1996.
4. The classic arguments against answering this question are given in R.D. Truog, "Doctor, If This Were Your Child, What Would You Do?" Pediatrics 103 (1999): 153-4; W. Ruddick, "Questions Parents Should Resist," in Children and Health Care: Moral and Social Issues, ed. L.M. Kopeland and J.C. Moskop (Dordrecht, The Netherlands: Kluwer Academic, 1989), 221-9; see also L.F. Ross, "Why 'Doctor, If This Were Your Child, What Would You Do?' Deserves an Answer," The Journal of Clinical Ethics (forthcoming).
5. The classic arguments against answering this question are given in R.D. Truog, "Doctor, If This Were Your Child, What Would You Do?" Pediatrics 103 (1999): 153-4; W. Ruddick, "Questions Parents Should Resist," in Children and Health Care: Moral and Social Issues, ed. L.M. Kopeland and J.C. Moskop (Dordrecht, The Netherlands: Kluwer Academic, 1989), 221-9; see also L.F. Ross, "Why 'Doctor, If This Were Your Child, What Would You Do?' Deserves an Answer," The Journal of Clinical Ethics (forthcoming).
6. The classic arguments against answering this question are given in R.D. Truog, "Doctor, If This Were Your Child, What Would You Do?" Pediatrics 103 (1999): 153-4; W. Ruddick, "Questions Parents Should Resist," in Children and Health Care: Moral and Social Issues, ed. L.M. Kopeland and J.C. Moskop (Dordrecht, The Netherlands: Kluwer Academic, 1989), 221-9; see also L.F. Ross, "Why 'Doctor, If This Were Your Child, What Would You Do?' Deserves an Answer," The Journal of Clinical Ethics (forthcoming).
7. M.J. Moore, B. O'Sullivan, and I.F. Tannock, "How Expert Physicians Would Wish to Be Treated if They Had Genitourinary Cancer," Journal of Clinical Oncology 6 (1988): 1736-45. More recently, a number of articles have been written to show that practice patterns differ for many conditions when treated by physicians from different specialties. See, for example, N.L. Keating et al., "Discussion of Treatment Options for Early-Stage Breast Cancer: Effect of Provider Specialty on Type of Surgery and Satisfaction," Medical Care 39 (2001): 681-91; J. McDonnell et al., "Effect of Physician Specialty on Treatment Recommendation to Patients with Coronary Artery Disease," International Journal of Technology Assessment in Health Care 16, no. 1 (2000): 190-8; S. Chow, "Specialty Group Differences over Tonsillectomy: Pediatricians versus Otolaryngologists," Qualitative Health Research 8 (1998): 61-75.
8. M.J. Moore, B. O'Sullivan, and I.F. Tannock, "How Expert Physicians Would Wish to Be Treated if They Had Genitourinary Cancer," Journal of Clinical Oncology 6 (1988): 1736-45. More recently, a number of articles have been written to show that practice patterns differ for many conditions when treated by physicians from different specialties. See, for example, N.L. Keating et al., "Discussion of Treatment Options for Early-Stage Breast Cancer: Effect of Provider Specialty on Type of Surgery and Satisfaction," Medical Care 39 (2001): 681-91; J. McDonnell et al., "Effect of Physician Specialty on Treatment Recommendation to Patients with Coronary Artery Disease," International Journal of Technology Assessment in Health Care 16, no. 1 (2000): 190-8; S. Chow, "Specialty Group Differences over Tonsillectomy: Pediatricians versus Otolaryngologists," Qualitative Health Research 8 (1998): 61-75.
9. M.J. Moore, B. O'Sullivan, and I.F. Tannock, "How Expert Physicians Would Wish to Be Treated if They Had Genitourinary Cancer," Journal of Clinical Oncology 6 (1988): 1736-45. More recently, a number of articles have been written to show that practice patterns differ for many conditions when treated by physicians from different specialties. See, for example, N.L. Keating et al., "Discussion of Treatment Options for Early-Stage Breast Cancer: Effect of Provider Specialty on Type of Surgery and Satisfaction," Medical Care 39 (2001): 681-91; J. McDonnell et al., "Effect of Physician Specialty on Treatment Recommendation to Patients with Coronary Artery Disease," International Journal of Technology Assessment in Health Care 16, no. 1 (2000): 190-8; S. Chow, "Specialty Group Differences over Tonsillectomy: Pediatricians versus Otolaryngologists," Qualitative Health Research 8 (1998): 61-75.
10. M.J. Moore, B. O'Sullivan, and I.F. Tannock, "How Expert Physicians Would Wish to Be Treated if They Had Genitourinary Cancer," Journal of Clinical Oncology 6 (1988): 1736-45. More recently, a number of articles have been written to show that practice patterns differ for many conditions when treated by physicians from different specialties. See, for example, N.L. Keating et al., "Discussion of Treatment Options for Early-Stage Breast Cancer: Effect of Provider Specialty on Type of Surgery and Satisfaction," Medical Care 39 (2001): 681-91; J. McDonnell et al., "Effect of Physician Specialty on Treatment Recommendation to Patients with Coronary Artery Disease," International Journal of Technology Assessment in Health Care 16, no. 1 (2000): 190-8; S. Chow, "Specialty Group Differences over Tonsillectomy: Pediatricians versus Otolaryngologists," Qualitative Health Research 8 (1998): 61-75.
11. See R.M. Veatch, The Patient-Physician Relation: The Patient as Partner (Bloomington, Ind.: Indiana University Press, 1991), especially the introduction and part I, "The Foundations of the Patient-Physician Relation," 1-46.
12. See R.M. Veatch, The Patient-Physician Relation: The Patient as Partner (Bloomington, Ind.: Indiana University Press, 1991), especially the introduction and part I, "The Foundations of the Patient-Physician Relation," 1-46.
13. The data on the influence on specialties regarding treatment preferences are cited in note 5. There are also data to show that practice variations are geographical and may be, in part, a reflection of where physicians received their training. See, for example, G.T. O'Connor et al., "Geographic Variation in the Treatment of Acute Myocardial Infarction: The Cooperative Cardiovascular Project," Journal of the American Medical Association 281 (1999): 627-33.
14. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.
15. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.
16. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.
17. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.
18. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.
19. The concept of patient-centered care is commonly associated with the work of the Picker Institute and its publication: Through the Patients's Eyes: Understanding and Promoting Patient-Centered Care, ed. M. Gerteis et al. (San Francisco: Jossey Bass, 1993). The concept has been applied in many different fields of medicine, and even in the design of healthcare facilities. For its imple-mentation in different fields of medicine, see, for example, H. Harrison, "The Principles for Family-Centered Neonatal Care," Pediatrics 92 (1993): 643-50; C.L. Collette, M.J. Costa, and C.L. Guglielmi, Practical Innovations: Ambulatory Surgery Approach Fosters Excellence in Patient-Centered Care and a Better Workplace," AORN Journal 70 (1999): 115-9; and J. M. Martin-Arafeh, C.L. Watson, and S.M. Baird, "Promoting Family-Cen-tered Care in High Risk Pregnancy," Journal of Perinatal and Neonatal Nursing. 13, no. 1 (1999); 27-42. For its influence in the architecture of healthcare systems, see, for example, L.P. Acton et al., "Children's Health Design: Designing for FamilyCentered Care," Journal of Healthcare Design (1997): 129-35; and G. Stout, "Patient-Focused Care from the Ground Up," Journal of Health Care Resource Management 13, no. 2 (1995): 17-22.