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When Competent Patients Make Irrational Choices

1990; Massachusetts Medical Society; Volume: 322; Issue: 22 Linguagem: Inglês

10.1056/nejm199005313222209

1533-4406

Dan W. Brock, Steven A. Wartman,

Ethics in medical practice

In recent years, physicians and patients have tended to move toward shared decision making. Although it sounds reasonable on the surface that patients and physicians should collaborate in making decisions about medical care, surprisingly little attention has been given to the complex and troubling issues that can arise. In particular, what does shared decision making imply for a physician's responsibilities when an apparently competent patient's choice appears to be irrational? A discussion of this issue requires a taxonomy of the different sources and forms of irrational decision making. We believe such a taxonomy should include the bias toward the present . . .