Selecting Treatment Options and Choosing Between them: Delineating Patient and Professional Autonomy in Shared Decision-Making

Cave, Emma

Abstract

Professional control in the selection of treatment or investigatory options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies that have potential to elevate the importance of patient and family preferences. In combination, they may be perceived by healthcare professionals as an obligation to follow patient preferences, even where doing so conflicts with other professional obligations. It is argued that a more nuanced approach to shared decision-making could help clarify the boundaries of decision-making responsibility.

Citation

Cave, E. (2020). Selecting Treatment Options and Choosing Between them: Delineating Patient and Professional Autonomy in Shared Decision-Making. Health Care Analysis, 28, 4-24. https://doi.org/10.1007/s10728-019-00384-8

• Journal Article Type: Article
• Acceptance Date: Aug 29, 2019
• Online Publication Date: Sep 21, 2019
• Publication Date: 2020
• Deposit Date: Sep 2, 2019
• Publicly Available Date: Sep 25, 2019
• Journal: Health Care Analysis
• Print ISSN: 1065-3058
• Electronic ISSN: 1573-3394
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Pages: 4-24
• DOI: https://doi.org/10.1007/s10728-019-00384-8
• Public URL: https://durham-repository.worktribe.com/output/1323811