An economic theory of patient decision-making
Journal of Bioethical Inquiry 2 (3) (2005)
| Abstract | Patient autonomy, as exercised in the informed consent process, is a central concern in bioethics. The typical bioethicist's analysis of autonomy centers on decisional capacity—finding the line between autonomy and its absence. This approach leaves unexplored the structure of reasoning behind patient treatment decisions. To counter that approach, we present a microeconomic theory of patient decision-making regarding the acceptable level of medical treatment from the patient's perspective. We show that a rational patient's desired treatment level typically departs from the level yielding an absence of symptoms, the level we call ideal. This microeconomic theory demonstrates why patients have good reason not to pursue treatment to the point of absence of physical symptoms. We defend our view against possible objections that it is unrealistic and that it fails to adequately consider harm a patient may suffer by curtailing treatment. Our analysis is fruitful in various ways. It shows why decisions often considered unreasonable might be fully reasonable. It offers a theoretical account of how physician misinformation may adversely affect a patient's decision. It shows how billing costs influence patient decision-making. It indicates that health care professionals' beliefs about the ‘unreasonable’ attitudes of patients might often be wrong. It provides a better understanding of patient rationality that should help to ensure fuller information as well as increased respect for patient decision-making. | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| Options |
|
|||||||||
Download options| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,679 |
| External links |
 |
| Through your library | Configure |
Similar books and articlesMargaret P. Battin (1985). Non-Patient Decision-Making in Medicine: The Eclipse of Altruism. Journal of Medicine and Philosophy 10 (1):19-44.
Mark Parascandola, Jennifer Hawkins & Marion Danis (2002). Patient Autonomy and the Challenge of Clinical Uncertainty. Kennedy Institute of Ethics Journal 12 (3):245-264.
Alan Schwartz (2008). Medical Decision Making: A Physician's Guide. Cambridge University Press.
Rosamond Rhodes & Ian Holzman (2004). The Not Unreasonable Standard for Assessment of Surrogates and Surrogate Decisions. Theoretical Medicine and Bioethics 25 (4):367-386.
Jillian Craigie (2011). Competence, Practical Rationality and What a Patient Values. Bioethics 25 (6):326-333.
Roy Gilbar & Ora Gilbar (2009). The Medical Decision-Making Process and the Family: The Case of Breast Cancer Patients and Their Husbands. Bioethics 23 (3):183-192.
Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe (2011). Adherence, Shared Decision-Making and Patient Autonomy. Medicine, Health Care and Philosophy 15 (2):115-127.
Gretchen B. Chapman & Frank A. Sonnenberg (eds.) (2000). Decision Making in Health Care: Theory, Psychology, and Applications. Cambridge University Press.
Lars Sandman & Christian Munthe (2009). Shared Decision-Making and Patient Autonomy. Theoretical Medicine and Bioethics 30 (4):289-310.
Jos V. M. Welie & Sander P. K. Welie (2001). Patient Decision Making Competence: Outlines of a Conceptual Analysis. Medicine, Health Care and Philosophy 4 (2):127-138.
Analytics
Monthly downloads |
Added to index2009-01-28Total downloads9 ( #114,063 of 549,088 )Recent downloads (6 months)1 ( #63,317 of 549,088 )How can I increase my downloads? |
My notes
Discussion
