Patients' Preferences for Participation in Clinical Decision Making: A Review of Published Surveys

Abstract

Models of doctor-patient relations vary between “paternalistic” and “informative.” The paternalistic model emphasizes doctors' authority; alternative models allow patients to exercise their rights to autonomy. Published surveys indicate that most patients want to be informed about their diseases, that a proportion of patients want to participate in planning management of their illnesses, and that some patients would rather be completely passive and would avoid any information. The severity of the patients' conditions, and their being older, less well educated, and male are predictors of a preference for the passive role in the doctor-patient relationship, but demographic and situational characteristics explain only 20% or less of the variability in preferences. The only way a physician can gain insight into an individual patient's desire to participate in decision making is through direct enquiry. The ability to communicate health-related information and to determine the patients' desire to participate in medical decisions should be viewed as a basic clinical skill.

Index Terms:

• communication skills
• doctor-patient relations
• patients' preferences

Additional information

Notes on contributors

Jochanan Benbassat

Dr Benbassat is a professor of medicine and a research associate with the Health Research Policy Program at the JDC-Brookdale Institute in Jerusalem, Israel; Dr Pilpel is a senior lecturer in epidemiology in the Department of Community Health with the Faculty of Health Sciences at Ben-Gurion University of the Negev in Beer Sheva, where Ms Tidhar is a graduate student.