Clinicians can support shared decision making by assessing patients’ knowledge, eligibility for screening, and preferences for engagement—active, collaborative, or passive—in the decision making process.
AMA J Ethics. 2015;17(7):601-607. doi:
10.1001/journalofethics.2015.17.7.ecas1-1507.
Marc M. Beuttler, MA, Kara N. Goldman, MD, and Jamie A. Grifo, MD, PhD
Respect for informed, autonomous decision making demands that useful, if anxiety-provoking, information about age-related decline in fertility not be withheld from women.
Victims of sexual violence who are minors should not be forced to submit to a rape kit exam against their wishes since it might retraumatize the patient.
AMA J Ethics. 2018;20(1):36-43. doi:
10.1001/journalofethics.2018.20.1.ecas2-1801.
Guidelines for proceeding with a plan of care when family members have conflicting opinions about the patient’s wishes and the patient does not speak the same language as her physicians.
Rachel A. Mills, MS, Susanne B. Haga, PhD, and Geoffrey S. Ginsburg, MD, PhD
Clinical utility is a test’s contribution to health outcomes, while personal utility considers the psychosocial and lifestyle effects and the value of the information to the patient.
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.