Communication about Advance Directives: Are Patients Sharing Information with Physicians?

1992 ◽  
Vol 1 (4) ◽  
pp. 377-387 ◽  
Author(s):  
Suzanne B. Yellen ◽  
Laurel A. Burton ◽  
Ellen Elpern
Keyword(s):  
Decision Making ◽  
Medical Care ◽  
Advance Directives ◽  
Patient Participation ◽  
Medical Decision Making ◽  
Treatment Plan ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Medical Decision

Historically, patients have deferred to physicians′ judgments about appropriate medical care, thereby limiting patient participation in treatment decisions. In this model of medical decision making, physicians typically decided upon the treatment plan. Communication with patients focused on securing their cooperation in accepting a treatment decision that essentially had already been made.

Physicians' views on the influence of patient participation on treatment decisions - an explorative study

2007 ◽  
Vol 20 (3) ◽  
pp. 174-182 ◽  
Author(s):  
Elina Jaakkola
Keyword(s):  
Decision Making ◽  
Patient Participation ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Role Expectations ◽  
Customer Participation ◽  
Health Care Managers ◽  
Treatment Decision Making ◽  
Explorative Study ◽  
Significant Difference

While patient participation in treatment decisions is increasingly advocated in medical literature, patient demand has been considered to cause unnecessary prescribing. Using the concept of customer participation as discussed in services marketing and management literature as a theoretical base, the paper analyses the influence of patient participation on the medical service process and treatment decision-making. A qualitative, explorative study was conducted to investigate American and British physicians' views on patient participation in the treatment of osteoporosis and schizophrenia. It became evident that in the cases of both osteoporosis and schizophrenia, patients influence prescribing decisions despite the significant difference in their willingness and ability to participate. The manifestations of patient participation were divided into three groups: (1) resources, such as the patient's condition and information about it, and his/her preconceived notions and preferences, (2) actions, such as preparing for the service, negotiating decisions and implementing the treatment, and (3) the patient's role expectations and inclination to participate. The influence of such manifestations on prescribing decision-making is discussed in detail, and differences between the studied illnesses are explained. Implications to health-care managers and practitioners are discussed.

Informed Consent and Advance Directives

2004 ◽  
Vol 94 (2) ◽  
pp. 198-205
Author(s):  
Jay M. Baruch
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
End Of Life ◽  
Advance Directives ◽  
Medical Decision Making ◽  
Informed Decision ◽  
Ethical Framework ◽  
Medical Decision ◽  
Informed Decision Making ◽  
Popular Belief

Contrary to popular belief, a patient’s signature on a piece of paper does not constitute informed consent. This article describes the ethical framework of consent in the context of the larger process of informed decision making. The elements of informed consent are examined in practical terms. Common pitfalls are addressed, with strategies to help anticipate and resolve possible dilemmas. These important tools are integral to all levels of medical decision making, including those at the end of life. (J Am Podiatr Med Assoc 94(2): 198-205, 2004)

scholarly journals Anxiety-Driven Cardiopulmonary Complaints during COVID-19 Pandemic Outbreak

2021 ◽  
Author(s):  
Ofir Koren ◽  
Saleem Rajab ◽  
Mohammad Barbour ◽  
Moriah Shachar ◽  
Amit Shahar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Decision Making ◽  
Medical Care ◽  
Medical Decision Making ◽  
Anxiety Level ◽  
Medical Decision ◽  
High Anxiety ◽  
Cardiac Anxiety ◽  
Artery Disease ◽  
Anxiety Questionnaire

Background We intend to examine whether the COVID-19 outbreak influences medical decision-making (MDM) among Non-COVID patients. Method We recruit 287 patients who admit to ER department due to cardiovascular complaints. Anxiety level was measured using three questionnaires (GAD-7, Beck Inventory, and the cardiac anxiety questionnaire). A fourth survey was designed to assess MDM considerations. Results 64% of patients were male (median age 54). Almost half of the patients were found to have moderate to severe levels of anxiety.79.3% of patients reported that the outbreak influenced their MDM. 44.5% of patients sought medical care 2-3 from the onset of symptoms. Coronary artery disease was found in only 26 patients (9.1%). Almost half of the patients stated that they would have gone earlier if not for the current pandemic. Conclusion Non-COVID patients seeking medical care had a high anxiety level that directly affected decision-making and put them at unnecessary risk.

scholarly journals Implicit persuasion in medical decision-making

2018 ◽  
Vol 7 (2) ◽  
pp. 209-227
Author(s):  
Ellen G. Engelhardt ◽  
Arwen H. Pieterse ◽  
Anne M. Stiggelbout
Keyword(s):  
Decision Making ◽  
Patient Participation ◽  
Medical Decision Making ◽  
Treatment Options ◽  
Medical Decision ◽  
Potential Pitfall ◽  
Participation In Decision Making

Abstract If the arguments to support a recommendation are partly implicit, the free exchange of ideas between discussants can be hampered. In this paper, we will focus on the potential pitfall for clinicians when informing patients about treatment options: implicit persuasion. We will describe a set of implicitly persuasive behaviors observed during decision-making consultations, and reflect on how these behaviors could undermine efforts to stimulate patient participation in decision-making. We will also reflect on possible explanations for why clinicians exhibit such behaviors.

The impact of “significant others” on breast cancer patients’ treatment decision making.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 20-20
Author(s):  
Suepattra G. May ◽  
Katharine Rendle ◽  
Meghan Halley ◽  
Nicole Ventre ◽  
Allison W. Kurian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Treatment Decision ◽  
Significant Others ◽  
Medical Decision ◽  
Breast Cancer Patients ◽  
Treatment Decision Making ◽  
The Impact

20 Background: Shared medical decision making (SDM) has been lauded by advocates for its potential to democratize the patient-physician relationship. However, the practice of SDM is still conceived of as largely a dyadic moment that exists between the patient and the physician. Few studies have looked at the role of significant others (spouses, partners, family members and friends) in decision making or considered how discussions and actions outside the consultation room affect a patient’s medical decisions. This prospective study investigated the impact of significant others on the decision making deliberations of newly diagnosed breast cancer patients. Methods: Forty-one newly diagnosed breast cancer patients were interviewed at four critical time points throughout treatment to explore how they deliberated decisions with both care providers and significant others. Surveys assessing HRQOL, role preferences and treatment satisfaction along with EHR abstraction augmented interview data. Grounded theory analysis was used to identify recurrent themes in the qualitative data, and survey data were analyzed using IBM SPSS Statistics 20. Results: Emergent themes from our analysis identified several factors that patients consider when faced with cancer treatment decisions, including 1) presentation of treatment options 2) patient or significant other conflict/concordance with care team recommendations 3) perceived risk of recurrence and 4) short and long term impact of treatment on daily life. Participants stressed the need for clinicians to view patients beyond diagnosis and recognize their larger care network as influential factors in their decision making. Conclusions: Our interviews highlight how the current healthcare delivery structure rarely acknowledges the circles of care that can exert influence on decision making. Lack of attention to non-clinical others can lead to sub-optimal medical decision making because these influences are not adequately understood by clinicians. Findings from this study suggest the need to enhance clinicians’ and researchers’ understanding of the influence of others in patients’ treatment decision making, enabling them to intervene in these practices.

An Investigation of Medical Decision Making BIAS Using Patient Penal Status

2005 ◽  
Vol 49 (11) ◽  
pp. 1004-1008
Author(s):  
Stephane Timothee ◽  
Marc L Resnick
Keyword(s):  
Decision Making ◽  
Medical Care ◽  
Prescription Drugs ◽  
Medical Decision Making ◽  
Information Sources ◽  
Medical Decision ◽  
Decision Making Process ◽  
The Us ◽  
Patient Variables ◽  
To Receive

When providing medical care, doctors are constantly required to make complex decisions based on a wide variety of information sources. As the US health care system becomes more complex with managed care, new regulations for prescription drugs, and other factors, it will become easier for bias to be introduced into the decision making process. This study investigates medical treatment decisions and seeks to identify paths through which bias can be introduced. Patient penal status was used as a proxy for patient variables that in theory should not affect care decisions but in practice often do. The results of the study show that penal patients are less likely to receive required and recommended treatments and that these differences are not due to differences in race, age, or gender of the prisoner population. Additional research is needed to identify the organizational or contextual factors that lead to differences in the provision of medical care.

Sign in / Sign up

Export Citation Format

Share Document