Limits to Responsibility and Decision-Making

Abstract

Both Professors Engelhardt and Aroskar have addressed the issues of decision-making and responsibility in the delivery and receipt of health care services. Two basic questions emerge. First, who decides? And, second, wherein does responsibility lie? When it comes to decision-making, the answer is clear—I decide. I decide whether to use services that you give me. I decide whether to listen to the advice that you offer me. In fact, I even decide whether or not to seek services. It is all too easy for health professionals to imagine that they, in fact, make decisions that are followed by passive patients seeking their care. On the contrary, users of human service systems are not passive patients, nor are they even clients. They are conscious, decision-making consumers of services and the issue of responsibility is closely related to decision-making. How can I, a consumer of services, expect any service provider to take responsibility for decisions that I do not or refuse to make?