What do we mean by partnership in making decisions about treatment?

BMJ 1999;319:780-782 ( 18 September )

Education and debate

What do we mean by partnership in making decisions about treatment?

Cathy Charles, associate professor ^a, Tim Whelan, associate professor ^b, Amiram Gafni, professor ^a.

^a Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5, ^b Department of Medicine, McMaster University

Correspondence to: C Charles charlesc@fhs.mcmaster.ca

The first 150 words of the full text of this article appear below.

For many decades, the dominant approach to making decisions about treatment in the medical encounter has been one of paternalism.^1-7In recent years this model has been challenged by doctors, patients,medical ethicists, and researchers who advocate more of a partnershiprelation between doctors and patients. ² ^8-13 The reasons forthis challenge have been described in detail elsewhere and includethe rise of consumerism and the notion of consumer sovereigntyin healthcare decision making; the women's movement with its emphasison challenging medical authority; the passage of legislation focusingon patients' rights in health care; and small area variationsin doctors' practice patterns that seem unrelated to differencesin health status.⁷ Though the first three factors are seenas either contributors to or facilitators of patients' participationin making decisions about health care, the fourth highlights theimprecision or the "art" of medical care¹⁴: patients with similarclinical problems may . . . [Full text of this article]

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