AMA Journal of Ethics

Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.

Current policy requires separate informed consent for some Public Health Service increased-risk donors, and this can make shared decision making harder.

Whether a patient’s decisional regret constitutes a failure of shared decision making can depend on how a decision was made.

Decision making in health care demands that we balance multiple considerations, like quality of life, statistics, and how different options could affect others. Dr Brian Zikmund-Fisher shares his own experience as a patient and explains how decision science can help us navigate ethically complex health decisions.  

How information is provided can change a choice. Decision science helps reveal affective forecasting errors and can generate choices congruent with patients’ and families’ values.

Prognostic uncertainty about risk creates demand for ongoing communication and facilitated reflection about goals and values.

Despite challenges of decision making for unrepresented patients, few laws or policy statements offer solutions. This article offers 5 key things to do.

Prevention efforts can marginalize patients by stigmatizing certain behaviors, so distinguishing individual professionals’ preferences about those behaviors is critical.

A “simplicity strategy” suggests expressing respect for persons and empathy and models inclusive group inquiry, epistemic humility, and justice.

When an unproven intervention is a nanodrug, a physician’s role is especially difficult due to possibilities of unprecedented harms.