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Comment
. 2011 Jun;14(2):201-9.
doi: 10.1111/j.1369-7625.2011.00673.x. Epub 2011 Apr 27.

Final responsibility for treatment choice: the proper role of medical doctors?

Søren Holm  1
Affiliations
Comment

Final responsibility for treatment choice: the proper role of medical doctors?

Søren Holm. Health Expect. 2011 Jun.

Abstract

Aims: To analyse whether the traditional allocation of decision-making responsibility is still justifiable. And, if not to analyse the strength of claims made by other health care professions and by patients.

Background: Traditionally doctors have been responsible for choices of treatment, both in terms of deciding and in terms of taking responsibility for the decisions. But modern health care work often takes place in teams involving health care professionals from different professions as well as the patient. In such teams it may not be obvious who should be responsible for treatment choice.

Methods: Philosophical analysis of epistemic, ethical and organizational arguments, including analysis of the historical origins of these arguments.

Results: The epistemic, ethical and organizational arguments for maintaining a primary decision making role for doctors are not sound. Other health care professionals can, in some circumstances make stronger and more justified claims. The arguments against allocation decision making authority to patients are also invalid or unsound in many circumstances.

Conclusion: There are many situations in which final responsibility for treatment choice should rest with health care professionals who are not doctors and with patients.

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References

    1. Brody H. The Healer’s Power. New Haven, CT: Yale University Press, 1992.
    1. Murphy EK. Applications of the ‘captain of the ship’ doctrine. AORN Journal, 1990; 52: 863–866. - PubMed
    1. Hadad AM. The nurse/physician relationship and ethical decision making. AORN Journal, 1991; 53: 151–156. - PubMed
    1. Walker L, Gilson L. ‘We are bitter but we are satisfied’: nurses as street‐level bureaucrats in South Africa. Social Science and Medicine, 2004; 59: 1251–1261. - PubMed
    1. Vivian L, Marais A, McLaughlin S, Falkenstein S, Argent A. Relationships, trust, decision‐making and quality of care in a paediatric intensive care unit. Intensive Care Medicine, 2009; 35: 1593–1598. - PubMed