The medical decision-making process and the family: The case of breast cancer patients and their husbands

Bioethics 23 (3):183-192 (2009)
Objectives: The objectives of the study were (1) to assess similarities and differences between breast cancer patients and their husbands in terms of doctor-patient/spouse relationships and shared decision making; and (2) to investigate the association between breast cancer patients and husbands in terms of preference of type of doctor, doctor-patient relationship, and shared decision making regarding medical treatment. Method: Fifty-seven women with breast cancer, and their husbands, completed questionnaires measuring doctor-patient/spouse relationships (paternalism, autonomy), and decision making regarding medical treatment. Results: Patients believe they have a key role in the medical decision-making process (93%) and that the participation of their husbands, and their agreement with the decision, is important (84% and 89%, respectively). Both breast cancer patients and their husbands prefer a shared decision-making process to paternalistic or autonomy-based approaches. Conclusion: In contrast to legal and bioethical approaches, which focus on the patient as the primary decision maker, this study reflects a practical recognition of the role of the breast cancer patient's husband in the decision-making process. It also reflects a relational rather than an individualistic perception of patient autonomy.
Keywords patient autonomy  breast cancer patients  doctor‐patient/husband relationships  husband  paternalism  decision making
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DOI 10.1111/j.1467-8519.2008.00650.x
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John Hardwig (1990). What About the Family? Hastings Center Report 20 (2):5-10.

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