Medical decision making: Paternalism versus patient-centered (autonomous) care

Current Opinion in Critical Care

Volumn 14, Issue 6, 2008, Pages 708-713

  Rodriguez Osorio, Carlos A ^a   Dominguez Cherit, Guillermo ^a  

^a INSTITUTO NACIONAL DE CIENCIAS MÉDICAS Y NUTRICIÓN SALVADOR ZUBIRÁN   (Mexico)

Author keywords

Autonomy; Family centered care; Medical decision making; Paternalism; Patient centered care; Relational autonomy

Indexed keywords

CRITICALLY ILL PATIENT; CULTURAL FACTOR; FAMILY CENTERED CARE; INFORMED CONSENT; MEDICAL DECISION MAKING; MEDICAL ETHICS; MEDICAL INFORMATION; PATERNALISM; PATIENT AUTONOMY; PATIENT CARE; PHYSICIAN; REVIEW; SOCIAL ASPECT;

CRITICAL ILLNESS; DECISION MAKING; ETHICS, CLINICAL; ETHICS, MEDICAL; HUMANS; PATERNALISM; PATIENT-CENTERED CARE; PERSONAL AUTONOMY; PHYSICIAN-PATIENT RELATIONS; PROFESSIONAL-FAMILY RELATIONS;

EID: 57149102307     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/MCC.0b013e328315a611     Document Type: Review

References (29)

1. Beauchamp TL, Childress JF. Principles of biomedical ethics. Oxford: Oxford University Press; 2001.
2. Tuckett AG. On paternalism, autonomy and best interests: telling the (competent) aged-care resident what they want to know. Int J Nurs Pract 2006; 12:166-173.
3. Dykeman MJ, Dewhirst K. Voluntariness. In: Singer PA, Viens AM, editors. The Cambridge textbook of bioethics. Cambridge, USA: Cambridge University Press; 2008. pp. 31-35.
4. Charles CA, Whelan T, Gafni A, et al. Shared treatment decision making: what does it mean to physicians? J Clin Oncol 2003; 21:932-936.
5. Murray E, Pollack L, White M, Lo B. Clinical decision-making: patients' preferences and experiences. Patient Educ Couns 2007; 65:169-196. A large cross-sectional survey conducted among the American public using computer-assisted telephone interviewing. It found a diversity of responses regarding preferred approach. The main findings are that 62% of respondents preferred shared decision making, 28% preferred informed approach, and 9% preferred paternalism.
6. Butow PN, Maclean M, Dunn SM, et al. The dynamics of change: cancer patients' preferences for information, involvement and support. Ann Oncol 1997;8:857-863.
7. Mazur DJ, Hickam DH. Patients' preferences for risk disclosure and role in decision making for invasive medical procedures. J Gen Intern Med 1997; 12:114-117.
8. Schattner A. What do patients really want to know? OJM 2002; 95:135-136.
9. Sekimoto M, Asai A, Ohnishi M, et al. Patients' preferences for involvement in treatment decision making in Japan. BMC Fam Pract 2004; 5:1.
10. Hebert PC, Hoffmaster B, Glass KC. Truth telling. In: Singer PA, Viens AM, editors. The Cambridge textbook of bioethics. Cambridge, USA: Cambridge University Press; 2008. pp. 36-42.
11. Ho A. Relational autonomy or undue pressure? Family's role in medical decision-making. Scand J Caring Sci 2008; 22:128-135. This essay argues for a re-examination of the notions of autonomy and undue pressure in the contexts of patienthood and relational identity. In particular, it examines the characteristics of families and their role in adult patients' decision making. This paper argues that family involvement and consideration of family interests can be integral in promoting patients' overall agency.
12. Asch DA, Hansen-Flaschen J, Lanken PN. Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: conflicts between physicians' practices and patients' wishes. Am J Respir Crit Care Med 1995; 151:288-292.
13. Dworkin, G. Paternalism. In: Zalta EN, editor. The Stanford encyclopedia of philosophy. Winter 2005 ed. http://plato.stanford.edu/arehives/win2005/ entries/paternalism/.
14. Siegler M. Metaphors and models of doctor-patient relationship. In: Childress JF, editor. Practical reasoning in bioethics. Indiana: Indiana University Press; 1997. pp. 44-56.
15. Levinson W, Kao A, Kuby A, Thisted RA. Not all patients want to participate in decision making. A national study of public preferences. J Gen Intern Med 2005; 20:531-535.
16. Watanabe Y, Takahashi M, Kai I. Japanese cancer patient participation in and satisfaction with treatment-related decision-making: a qualitative study. BMC Public Health 2008; 8:77. This study revealed that Japanese cancer patients' preferences regarding their role in treatment-related decision making varied widely from complete physician control to complete patient control.
17. Adams RJ, Smith BJ, Ruffin RE. Patient preferences for autonomy in decision making in asthma management. Thorax 2001; 56:126-132.
18. Fraenkel L, Bogardus S, Concato J, Felson D. Preference for disclosure of information among patients with rheumatoid arthritis. Arthritis Rheum 2001; 45:136-139.
19. Asghari F, Mirzazadeh A1 Fotouhi A. Patients' preferences for receiving clinical information and participating in decision-making in Iran. J Med Ethics 2008; 34:348-352.
20. Murray E, Pollack L, White M, Lo B. Clinical decision-making: physicians' preferences and experiences. BMC Fam Pract 2007; 8:10. Cross-sectional survey of a nationally representative sample of US physicians. It showed the first data from a large nationally representative sample of physicians to explore physician perceptions of their preferred and perceived role in clinical decision making. The main findings are that three quarters of physicians prefer sharing decision making with their patients, with the remaining one quarter almost equally divided between the paternalist and consumerist approaches.
21. Azoulay E, Pochard F. Communication with family members of patients dying in the intensive care unit. Curr Opin Crit Care 2003; 9:545-550.
22. Berger JT, DeRenzo EG, Schwarte J. Surrogate decision making: reconciling ethical theory and clinical practice. Ann Intern Med 2008; 149:48-53. In this article, the authors outline differences between normative standards for decision making and empirical evidence of practice and offer clinicians ways in which the two can be reconciled for the patient's benefit.
23. Cohen S, Sprung C, Sjokvist P, et al. Communication of end-of-life decisions in European intensive care units. Intensive Care Med 2005; 31:1215-1221.
24. Levin PD, Sprung CL. Critical and intensive care ethics. In: Singer PA, Viens AM, editors. The Cambridge textbook of bioethics. Cambridge, USA: Cambridge University Press; 2008. pp. 462-468.
25. Coppolino M, Ackerson L. Do surrogate decision makers provide accurate consent for intensive care research? Chest 2001 ; 119:603-612.
26. Ciroldi M, Cariou A, Adrie C, et al. Ability of family members to predict patient's consent to critical care research. Intensive Care Med 2007; 33:807-813.
27. Azoulay E, Pochard F, Chevret S, et al. Half the family members of intensive care unit patients do not want to share in the decision-making process: a study in 78 French intensive care units. Crit Care Med 2004; 32:1832-1838.
28. Studdert DM, Mello MM, Burns JP, et al. Conflict in the care of patients with prolonged stay in the ICU: types, sources, and predictors. Intensive Care Med 2003; 29:1489-1497.
29. Engelhardt HT Jr. Critical care: why there is no global bioethics. Curr Opin Crit Care 2005; 11:605-609.