When Competent Patients Make Irrational Choices
Creator
Brock, Dan W.
Wartman, Steven A.
Bibliographic Citation
New England Journal of Medicine. 1990 May 31; 322(22): 1595-1599.
Abstract
Brock and Wartman explore what shared decision making in patient care implies for physicians when a seemingly competent patient makes apparently irrational choices. They describe a standard of rational decision making and a taxonomy of the different sources and forms of irrational decision making. This taxonomy includes a bias toward the present and near future, the belief that "it won't happen to me," fear of pain or of the medical experience, patients' wants or values that make no sense, framing effects in the way that choices are presented, and conflicts between individual and social rationality. Brock and Wartman argue that while it is often appropriate for physicians to attempt to persuade competent patients to reconsider irrational choices, these choices must be respected if the patient cannot be persuaded to change them. (KIE abstract)
Date
1990-05Subject
Alternative Therapies; Autonomy; Common Good; Communication; Competence; Consent; Decision Analysis; Decision Making; Forms; Health; Immunization; Informed Consent; Illness; Moral Obligations; Motivation; Pain; Paternalism; Patient Care; Patient Participation; Patients; Physicians; Professional Patient Relationship; Public Health; Resource Allocation; Self Induced Illness; Standards; Treatment Refusal; Uncertainty; Values;
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When Competent Patients Make Irrational Choices
Brock, Dan W. and Wartman, Steven A. (1990-05-31)