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The Patient's Role in Clinical Decision-Making

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▸Requests for reprints should be addressed to David S. Brody, M.D.; Division of General Internal Medicine, Temple University School of Medicine, 3401 North Broad Street; Philadelphia, PA 19140.

© 1980 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1980;93(5):718-722. doi:10.7326/0003-4819-93-5-718
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Practicing physicians must frequently make decisions about how much they wish to encourage patient participation in clinical decision-making and how to respond to rational patient demands that do not coincide with their own decisions. These are difficult ethical dilemmas with no indisputable or universal solutions. The traditional concept of the doctor-patient relationship places the patient in a passive, compliant role. The patient's only obligation is to seek competent help and cooperate with the physician. A number of factors have contributed to the continued dominance of the traditional doctor-patient imbalance of power. Despite these factors, there seems to be a great deal of public dissatisfaction with health care delivery in the United States; demands for more patient autonomy are increasing. This paper dicusses the concept of mutual participation, presents an approach to encouraging patient participation in clinical decision-making, and considers its theoretical advantages.





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