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May 10, 2000

How Should Physicians Involve Patients in Medical Decisions?—Reply

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

In Reply: We agree with Dr Gates that trust in the patient-physician relationship influences the style of decision making. However, physicians may assume that patients desire a paternalistic posture, despite evidence to the contrary.1,2 Patients want physicians they trust to make sound recommendations; they do not want physicians to exclude them from any potential role in decision making. Furthermore, even if patients rationally delegated their decisional authority to their physicians,3 physicians should still say enough to make their reasoning clear to the patient and work to foster understanding.

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