| Evidence, Values, Guidelines and Rational Decision-making. | |
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MedLine Citation:
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PMID: 21971602 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Medical decision-making involves choices, which can lead to benefits or to harms. Most benefits and harms may or may not occur, and can be minor or major when they do. Medical research, especially randomized controlled trials, provides estimates of chance of occurrence and magnitude of event. Because there is no universally accepted method for weighing harms against benefits, and because the ethical principle of autonomy mandates informed choice by patient, medical decision-making is inherently an individualized process. It follows that the practice of aiming for universal implementation of standardized guidelines is irrational and unethical. Irrational because the possibility of benefits is implicitly valued more than the possibility of comparable harms, and unethical because guidelines remove decision making from the patient and give it instead to a physician, committee or health care system. This essay considers the cases of cancer screening and diabetes management, where guidelines often advocate universal implementation, without regard to informed choice and individual decision-making. |
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Authors:
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Bruce Barrett |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-5 |
Journal Detail:
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Title: Journal of general internal medicine Volume: - ISSN: 1525-1497 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8605834 Medline TA: J Gen Intern Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Family Medicine, University of Wisconsin, 1100 Delaplaine Ct., Madison, WI, USA, bruce.barrett@fammed.wisc.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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