Deference to patients risk attitudes is contingent on medical norms

Makin argues that doctors1 should defer to each patient’s attitude to risk, over and above standard, utility-based and outcome-focussed medical decision-making models, in selecting treatment options for that patient.1 Although Makin articulates the problem as a dilemma of whether ‘to give the treatment or to withhold it’, it can be assumed that his question is whether the doctor should offer a certain treatment; because both the General Medical Council and law require doctors to engage patients in shared decision-making (SDM) and to obtain consent before ‘giving’ any treatment. Yet, Makin is correct in asserting that doctors ‘make choices on behalf of their patients on a daily basis’ insofar that doctors do have to make certain a priori decisions. SDM requires a starting point—a range of clinically appropriate or reasonable options—on which patients and doctors can collaboratively deliberate in order to reach a treatment decision; and...

Source: Journal of Medical Ethics - October 23, 2023 Category: Medical Ethics Authors: Sarela, A. I. Tags: Commentary Source Type: research