Physicians' personal values in determining medical decision-making capacity: a survey study

Area of Science:

• Medical Ethics
• Clinical Psychology

Background:

• Decision-making capacity (DMC) evaluations are crucial for patient autonomy.
• These evaluations are influenced by normative judgments and personal values.
• The relationship between physicians' values and DMC evaluations remains under-explored.

Purpose of the Study:

• To investigate the empirical relationship between physicians' value profiles and their use of risk-relative standards in DMC evaluations.
• To explore how physicians' personal values impact the stringency of capacity assessments.

Main Methods:

• A survey study was conducted among physicians.
• Physicians' value profiles were assessed.
• The use of risk-relative standards in capacity evaluations was examined in relation to these values.

Main Results:

• Physicians' values significantly influence DMC evaluations.
• Higher scores in achievement, power, face, and conformity values correlated with applying risk-relative standards.
• Emphasis on hedonism, rule conformity, and universalism correlated with applying equal standards regardless of risk.

Conclusions:

• Physicians' personal values demonstrably impact decision-making capacity evaluations.
• A notable portion of physicians are unaware of this influence, necessitating increased sensitization.
• The findings raise ethical considerations regarding the inherent influence of physicians' values in clinical practice.