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According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
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Ethics is a philosophical study of moral actions. Ethics attempts to determine what is valuable for individuals and society. It examines the rational justification of moral judgments and analyzes what is morally just, fair, and right. Bioethics is a sub-discipline of applied ethics that analyzes the philosophical, social, and legal issues in life sciences and medicine. Ethical theories serve as a foundation for decision-making and represent the viewpoints from which people seek direction. They...
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Patients, doctors and risk attitudes.

Nicholas Makins1

  • 1Philosophy, King's College London, London, UK ndmakins@gmail.com.

Journal of Medical Ethics
|March 10, 2023
PubMed
Summary

Healthcare professionals should respect patients' risk attitudes in medical decisions, extending anti-paternalistic principles. This approach requires considering patients' higher-order preferences for a nuanced understanding of medical decision-making.

Area of Science:

  • Decision Theory
  • Medical Ethics
  • Behavioral Economics

Background:

  • Widespread evidence of risk-averse and risk-seeking behaviors in decision-making.
  • Rational permissibility of diverse risk attitudes is increasingly accepted.
  • Clinical medicine involves healthcare professionals making choices for patients, complicating decision norms.

Purpose of the Study:

  • To determine whose risk attitude (doctor's or patient's) is relevant in medical decision-making.
  • To explore whether doctors should be risk-averse when choosing for others.
  • To argue for a deferential approach prioritizing the patient's risk attitude.

Main Methods:

  • Extending arguments for anti-paternalism in medicine to encompass patients' risk attitudes.
  • Analyzing the implications of patient risk attitudes in medical decision-making.
Keywords:
Decision-makingEthics

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  • Refining the deferential approach by considering patients' higher-order attitudes towards risk.

    • Main Results:

    • Arguments for anti-paternalism can be extended to include patients' risk attitudes, not just health state evaluations.
    • A deferential approach, prioritizing patient risk attitudes, is proposed for medical decision-making.
    • The deferential view requires refinement to account for higher-order risk preferences and differing theories of risk attitudes.

    Conclusions:

    • Healthcare professionals ought to adopt a deferential approach, respecting the patient's risk attitude.
    • This approach aligns with anti-paternalistic principles and patient autonomy in healthcare.
    • Further consideration of patients' meta-attitudes towards risk is necessary for a comprehensive model.