Advanced

The ethics of risk communication in lifestyle interventions: Consequences of patient centredness

Eriksson, Tina; Nilstun, Tore LU and Edwards, Adrian (2007) In Health, Risk and Society 9(1). p.19-36
Abstract
Background: Broader patient access to information, expanding clinical options and greater accommodation of patients' personal values makes clinical decision-processes increasingly complex. Given the challenges and implications of risk communication, it is important to explore what is happening when clinicians adopt different approaches to consultations. Aim: To perform an ethical analysis of personal risk communication based around a scenario of cardiovascular risk reduction by exploring how different consultation models raise different ethical implications. Method: We based our analysis on the triangle of autonomy, utility and justice. Because ethical questions arise during consultations, consultation approach is a basic context for... (More)
Background: Broader patient access to information, expanding clinical options and greater accommodation of patients' personal values makes clinical decision-processes increasingly complex. Given the challenges and implications of risk communication, it is important to explore what is happening when clinicians adopt different approaches to consultations. Aim: To perform an ethical analysis of personal risk communication based around a scenario of cardiovascular risk reduction by exploring how different consultation models raise different ethical implications. Method: We based our analysis on the triangle of autonomy, utility and justice. Because ethical questions arise during consultations, consultation approach is a basic context for interpretations. We chose four distinct approaches; paternalistic, shared decision-making, mandatory autonomist and narrative. Results: The ethical principles of autonomy, utility and justice proved ambiguous. Tradeoffs exist between principles to balance the rights of individual patients (autonomy and protection of personal rights and the patient's personal view on utility), with medical utility seen from the perspective of the health care system (with limited resources), equity and solidarity. Patient centredness is believed to enhance trust in the doctor -patient relationship, but the decisional authority given to patients in such approaches may hazard biomedical utility in the individual consultation and make prioritizing between tasks in the health care sector difficult. Conclusion: The consultation style of the GP has implications for the individual patient, for population health and for the cost of health care. This debate is unavoidable. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
physician-patient relations, life style, humans, health services, health, family practice, theory, ethics, decision-making, attitude of health personnel, communication, public health, risk, risk communication, risk assessment
in
Health, Risk and Society
volume
9
issue
1
pages
19 - 36
publisher
Taylor & Francis
external identifiers
  • wos:000245984100003
  • scopus:33847746124
ISSN
1469-8331
DOI
10.1080/13698570601181615
language
English
LU publication?
yes
id
41f163cb-d2c9-47c9-b818-5a21f8fc9eab (old id 663578)
date added to LUP
2007-12-10 09:10:12
date last changed
2017-01-01 05:13:56
@article{41f163cb-d2c9-47c9-b818-5a21f8fc9eab,
  abstract     = {Background: Broader patient access to information, expanding clinical options and greater accommodation of patients' personal values makes clinical decision-processes increasingly complex. Given the challenges and implications of risk communication, it is important to explore what is happening when clinicians adopt different approaches to consultations. Aim: To perform an ethical analysis of personal risk communication based around a scenario of cardiovascular risk reduction by exploring how different consultation models raise different ethical implications. Method: We based our analysis on the triangle of autonomy, utility and justice. Because ethical questions arise during consultations, consultation approach is a basic context for interpretations. We chose four distinct approaches; paternalistic, shared decision-making, mandatory autonomist and narrative. Results: The ethical principles of autonomy, utility and justice proved ambiguous. Tradeoffs exist between principles to balance the rights of individual patients (autonomy and protection of personal rights and the patient's personal view on utility), with medical utility seen from the perspective of the health care system (with limited resources), equity and solidarity. Patient centredness is believed to enhance trust in the doctor -patient relationship, but the decisional authority given to patients in such approaches may hazard biomedical utility in the individual consultation and make prioritizing between tasks in the health care sector difficult. Conclusion: The consultation style of the GP has implications for the individual patient, for population health and for the cost of health care. This debate is unavoidable.},
  author       = {Eriksson, Tina and Nilstun, Tore and Edwards, Adrian},
  issn         = {1469-8331},
  keyword      = {physician-patient relations,life style,humans,health services,health,family practice,theory,ethics,decision-making,attitude of health personnel,communication,public health,risk,risk communication,risk assessment},
  language     = {eng},
  number       = {1},
  pages        = {19--36},
  publisher    = {Taylor & Francis},
  series       = {Health, Risk and Society},
  title        = {The ethics of risk communication in lifestyle interventions: Consequences of patient centredness},
  url          = {http://dx.doi.org/10.1080/13698570601181615},
  volume       = {9},
  year         = {2007},
}