학술논문

Setting Boundaries: Public Views on Limiting Patient and Physician Autonomy in Health Care Decisions.
Document Type
Article
Source
Journal of Health Politics, Policy & Law. Aug2017, Vol. 42 Issue 4, p579-605. 27p. 2 Charts.
Subject
*ANTIBIOTICS
*AUTONOMY (Psychology)
*GROUNDED theory
*HEALTH care rationing
*HEALTH education
*INSURANCE companies
*CASE studies
*MEDICAL care use
*HEALTH policy
*MEDICAL protocols
*PATIENT safety
*PHYSICIAN-patient relations
*PROFESSIONS
*PUBLIC opinion
*RESEARCH funding
*VALUES (Ethics)
*EVIDENCE-based medicine
*DECISION making in clinical medicine
*SOCIOECONOMIC factors
*THEMATIC analysis
*INAPPROPRIATE prescribing (Medicine)
*PATIENT autonomy
*PATIENT decision making
Language
ISSN
0361-6878
Abstract
We obtained and qualitatively analyzed input from more than nine hundred citizens during seventy-six public deliberation sessions about patient and physician autonomy in decision making, setting health care boundaries, and the tensions among competing social values. Generally, participants resisted interference with the patient-physician relationship and believed strongly in the freedom of patient and physician to control individual medical decisions. However, during deliberation participants identified two situations where boundaries and regulations in health care were more acceptable: protecting people from harm and allocating limited resources. The core value of individual freedom was tempered in varying degrees by the values of concern for the greater good and fairness in allocating resources. Where tensions between values emerged, participants used different concepts--including accountability, transparency, trust, personal responsibility, and moral obligation--to navigate trade-offs. Fairly balancing the public's desire to protect individual freedom with their sense of responsibility for protecting the common good may be the key to developing acceptable, workable policies that promote evidence-based medical practice. [ABSTRACT FROM AUTHOR]