Health care: the challenge to deal with uncertainty and value judgment

The exponential increase of knowledge in the life sciences field, more specifically in health sciences, in the past few years has brought additional levels of complexity when deciding and implementing strategies in the health care system. A predominantly paternalistic way to decide about available options to maintain or improve individual or collective health has been moving to a shared-decision model considering the empowered patient. In spite of the reduction of uncertainty when making health and health care decisions due to the advancement in scientific methods, and, in spite of the asymmetry of information, knowledge and power to make decisions, we are progressively recognizing the importance of individuals, the target of the intervention, to express their preferences and to take an active role in the decision making process. Health care stakeholders, recognizing the scarcity of resources available and the fortunate ever increasing amount of applicable knowledge and its corresponding interventions to improve the population quantity and quality of life, should stimulate society to address and discuss health care issues that will guide critical choices and define health care priorities based mostly on judgment and the best evidence available.