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May 10, 2000

How Should Physicians Involve Patients in Medical Decisions?

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(18):2390-2392. doi:10.1001/jama.283.18.2387

To the Editor: We wish to suggest an entirely different interpretation of Dr Braddock and colleagues'1 dismal finding that physicians failed to meet a standard for informed consent 91% of the time. Rather than indicting physicians, these findings challenge the standards themselves.

In recent decades, studies like those of Braddock et al have established that the practice of informed consent is far removed from its theory. Meanwhile, ethicists have crept toward what could be called mandatory autonomy—the view that patients should make their own decisions whether they want to or not.2 In other words, ethicists have increasingly made the standards for informed consent more stringent even as empiricists have increasingly shown how rarely they are met.

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