Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy. Issue 11 (2nd November 2017)

• Record Type: Journal Article
• Authors: Ubel, Peter A.; Scherr, Karen A.; Fagerlin, Angela
• Is Part Of: American journal of bioethics. Volume 17:Issue 11(2017)
• Page Start: 31
• Page End: 39
• Publication Date: 2017-11-02
• Subjects: autonomy -- informed consent -- physician/patient communication -- shared decision making; Bioethics -- Periodicals; Medical ethics -- Periodicals; 174.957
• DOI: 10.1080/15265161.2017.1378753
• Languages: English
• ISSNs: 1526-5161

Abstract

Abstract : Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals.