ISSN 印刷: 2151-805X
ISSN オンライン: 2151-8068
Shared Decision Making Still a Goal and Not a Practice: How One Physician Learned about the Other Side, The Patient's Perspective
要約
Shared decision making (SDM) is the ethical standard of care in the United States. Whereas most doctors accept and understand SDM from an intellectual perspective, they find it hard not to be a paternalistic advisor. The major reason doctorc cannot let go of paternalism is that they want to do what they think is right for the patient knowing most patients do not understand the complexity of diagnosis and treatment. Other reasons include: limited time to explain due to pressure to produce, old habits are hard to change, people in power are afraid to do anything to affect their status, and doctors are afraid to look weak, or they don't
know, understand, or accept the revised ethical standard.
I witnessed these problems first hand when both of my parents fell sick and had to be hospitalized. As their health care proxy and a loving son, I felt duty bound to follow their wishes to the "T." Both of my parents were patients in major teaching hospitals in New York City.
Their respective staff members should have been well aware of the change to SDM. However, doctors often discussed options without allowing for dissension.
I use my parents' stories as a means to point out decision nodes in their care and to discuss ethics of shared decision making.