Patient preferences regarding spine surgical decision making

Area of Science:

• Orthopedic Surgery
• Medical Ethics
• Health Psychology

Background:

• The historical trend favors increased patient autonomy in healthcare decisions.
• Patients are increasingly encouraged to actively participate in surgical decision-making.
• Empirical data on the extent of patient involvement desired in surgical decisions remains limited.

Purpose of the Study:

• To assess spine patient preferences for physician versus patient roles in surgical decision-making.
• To explore the ethical implications of varying patient involvement in treatment choices.
• To understand patient desires regarding information disclosure and decision authority.

Main Methods:

• Utilized validated questionnaires administered to 200 consecutive patients at an academic spine center.
• Assessed patient preferences concerning the process of clinical decision-making.
• Employed patient surveys to determine specific preferences in surgical decision-making.

Main Results:

• Patients strongly desire comprehensive disclosure of all risks associated with surgical options.
• A majority of patients prefer the physician to make the primary treatment decision.
• The overwhelming majority of patients believe the physician should make the technical decisions regarding treatment.

Conclusions:

• Spine surgery patients frequently opt to delegate decision-making authority to their surgeons.
• When evidence is clear and non-controversial, patient deference has minimal impact if surgeons provide evidence-based care.
• In complex or controversial cases, patient education and value-based decision support are essential.