The ethics of evidence-based patient choice

In this paper I analyse the ethical implications of the concept of 'evidence-based patient choice' in the light of criticism of the 'individualism' of patient-centred medicine. I argue that individualism in the sense used by the critics of patient centred medicine is not an inevitable consequence of an emphasis on patient choice and that a concern with the promotion of individual choices is not incompatible with 'communitarian' values. Indeed, I argue that any ethical approach to decision-making in health-care must be capable of taking seriously both the moral status of the individual (and of his or her choices) and the moral significance of the social dimensions of such choices. The best way to ensure respect for the principle of autonomy, I suggest, is to facilitate and encourage social interactions of a particular, deliberative, kind. This is also the best way to ensure that the broader public interest is taken into account in decision-making.