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Comment & Response
June 2016

Against “Healthy Paternalism” at the End of Life

Author Affiliations
  • 1Department of Pediatric Oncology, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
  • 2Office of Ethics, Boston Children’s Hospital, Boston, Massachusetts
  • 3Center for Bioethics, Harvard Medical School, Boston, Massachusetts
  • 4Division of Critical Care Medicine, Boston Children’s Hospital, Boston, Massachusetts
JAMA Oncol. 2016;2(6):832. doi:10.1001/jamaoncol.2016.1390

To the Editor Unfortunately, shared decision making is often misunderstood as simply asking the patient to choose from a list of possible options. But a decision that is truly shared requires the physician to help guide the patient toward options that are most consistent with the patient’s values and preferences, given the physician’s knowledge of the patient’s clinical situation and the pros and cons of the various options.1 Furthermore, physicians have an obligation to provide recommendations to patients, based on the outcome of these discussions.

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