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March 2, 2005

Shared Medical Decision Making

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(9):1058-1059. doi:10.1001/jama.293.9.1058-b

To the Editor: Paternalism in medical care is dead; long live neopaternalism. Such is the disheartening conclusion we reach upon reading Dr McNutt’s Commentary on shared medical decision making.1 Arguing for a model of informed decision making based upon a concept of mandatory autonomy, McNutt asserts that “the consequences of a patient’s choices cannot be shared with anyone else,” and therefore, “physicians should never make a choice for a patient—even if the patient wants [it].” Furthermore, he believes that patients, when required to reflect on quantified benefits and burdens of treatment, “will learn to accept the responsibility of choosing” and follow a utilitarian model of “the best course of action for decision making.”

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