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Predictors of hospitalised patients' preferences for physician-directed medical decision-making.

Publication ,  Journal Article
Chung, GS; Lawrence, RE; Curlin, FA; Arora, V; Meltzer, DO
Published in: J Med Ethics
February 2012

BACKGROUND: Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. OBJECTIVE: To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. METHODS: Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. RESULTS: Data were collected from 8308 of 11,620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). CONCLUSIONS: Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small.

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Published In

J Med Ethics

DOI

EISSN

1473-4257

Publication Date

February 2012

Volume

38

Issue

2

Start / End Page

77 / 82

Location

England

Related Subject Headings

  • Spirituality
  • Religion
  • Physician-Patient Relations
  • Patient-Centered Care
  • Patient Preference
  • Patient Participation
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Chung, G. S., Lawrence, R. E., Curlin, F. A., Arora, V., & Meltzer, D. O. (2012). Predictors of hospitalised patients' preferences for physician-directed medical decision-making. J Med Ethics, 38(2), 77–82. https://doi.org/10.1136/jme.2010.040618
Chung, Grace S., Ryan E. Lawrence, Farr A. Curlin, Vineet Arora, and David O. Meltzer. “Predictors of hospitalised patients' preferences for physician-directed medical decision-making.J Med Ethics 38, no. 2 (February 2012): 77–82. https://doi.org/10.1136/jme.2010.040618.
Chung GS, Lawrence RE, Curlin FA, Arora V, Meltzer DO. Predictors of hospitalised patients' preferences for physician-directed medical decision-making. J Med Ethics. 2012 Feb;38(2):77–82.
Chung, Grace S., et al. “Predictors of hospitalised patients' preferences for physician-directed medical decision-making.J Med Ethics, vol. 38, no. 2, Feb. 2012, pp. 77–82. Pubmed, doi:10.1136/jme.2010.040618.
Chung GS, Lawrence RE, Curlin FA, Arora V, Meltzer DO. Predictors of hospitalised patients' preferences for physician-directed medical decision-making. J Med Ethics. 2012 Feb;38(2):77–82.

Published In

J Med Ethics

DOI

EISSN

1473-4257

Publication Date

February 2012

Volume

38

Issue

2

Start / End Page

77 / 82

Location

England

Related Subject Headings

  • Spirituality
  • Religion
  • Physician-Patient Relations
  • Patient-Centered Care
  • Patient Preference
  • Patient Participation
  • Middle Aged
  • Male
  • Humans
  • Female