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The Patient - Patient-Centered Outcomes Research

, Volume 10, Issue 5, pp 537–539 | Cite as

Revolutionizing Informed Consent: Empowering Patients with Certified Decision Aids

  • Thaddeus Mason PopeEmail author
  • Daniel Lessler
Commentary

The doctrine of informed consent has been part of US law for decades. But it has failed to meaningfully empower patients to make diagnostic and treatment decisions that match their preferences [1]. Too frequently, clinicians misunderstand patient preferences and provide unwanted treatment.

Significant data illustrates the gap between theory and practice. For example, a 2014 study of patients scheduled for elective cardiac catheterization found that 88% of patients held fundamentally mistaken beliefs about the potential benefits of the procedure, despite having signed an informed consent document [2]. Similar examples abound. Only 19% of patients with colorectal cancer understood that chemotherapy was not likely to cure their cancer [3]. Only 10% of spine clinic patients could answer basic questions about their spinal surgery [4]. Only 5% of cancer patients understood essential aspects of their diagnosis [5]. Only 3% of patients scheduled for percutaneous coronary intervention...

Keywords

Shared Decision Medicaid Service Accountable Care Organization Chief Medical Officer Health Care Authority 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with ethical standards

Conflict of interest

Thaddeus Pope and Daniel Lessler declare no confllicts of interest.

References

  1. 1.
    Pope TM. Certified patient decision aids: solving persistent problems with informed consent law. J Law Med Ethics. 2017;45 (forthcoming).Google Scholar
  2. 2.
    Kureshi F, Jones PG, Buchanan DM, Abdallah MS, Spertus JA. Variation in patients’ perceptions of elective percutaneous coronary intervention in stable coronary artery disease: cross sectional study. BMJ. 2014;349:g5309.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Weeks JC, et al. Patients’ expectations about effects of chemotherapy for advanced cancer. New Eng J Med. 2012;367:1616–25.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Weckbach S, et al. A survey on patients’ knowledge and expectations during informed consent for spinal surgery: can we improve the shared decision-making process? Patient Saf Surg. 2016;10(15):1–4.Google Scholar
  5. 5.
    Epstein AS, et al. Discussions of life expectancy and changes in illness understanding in patients with advanced cancer. J Clin Oncol. 2016;34(20):2398–403.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Kureshi F, et al. Variation in patients’ perceptions of elective percutaneous coronary nation in stable coronary artery disease: cross sectional study. BMJ. 2014;349(g5309):1–13.Google Scholar
  7. 7.
    Stacey D, Légaré F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;1:CD001431.Google Scholar
  8. 8.
    Blair L, Légar F. Is shared decision making a utopian dream or an achievable goal? Patient. 2015;8(6):471–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Hawley ST, Newman L, Griggs JJ, et al. Evaluating a decision aid for improving decision making in patients with early-stage breast cancer. Patient. 2016;9(2):161–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Alston C, Berger Z, Brownlee S, Elwyn G, Fowler FJ, Hall LK, Montori VM, Moulton B, Paget L, Haviland-Shebel B, Singerman R, Walker J, Wynia MK, Henderson D. Shared decision-making strategies for best care: patient decision aids (Institute of Medicine, Sept 2014). http://nam.edu/perspectives-2014-shared-decision-making-strategies-for-best-care-patient-decision-aids/

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Mitchell Hamline School of LawSaint PaulUSA
  2. 2.Washington Health Care AuthorityOlympiaUSA

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