{"id":32870,"date":"2014-12-01T11:48:10","date_gmt":"2014-12-01T10:48:10","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=32870"},"modified":"2014-12-02T11:24:14","modified_gmt":"2014-12-02T10:24:14","slug":"the-bmj-today-unravelling-the-notion-of-informed-patient-choice","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/01\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\/","title":{"rendered":"The BMJ Today: Unravelling the notion of informed patient choice"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-21350\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2012\/10\/anita_jain.jpg\" alt=\"\" width=\"106\" height=\"160\" \/>\u201cDoctor, what would you do in my shoes?\u201d This simple plea for advice from a patient may stump many a doctor.<\/p>\n<p>Involving patients in decisions about their care is increasingly regarded as the sine qua non of medical practice. <a href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/11\/27\/anna-mead-robson-in-defence-of-paternalism\/?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&amp;g=w_bmj-com\">Anna Mead Robson cautions, however<\/a>, \u201cthat by continuing to champion patient choice at the expense of &#8216;old fashioned&#8217; paternalism we risk depriving some patients of the advice and relief they are seeking.\u201d<!--more--><\/p>\n<p>Drawing on her days as a patient, she writes of times when she longed for decisions to be made on her behalf. Indeed, if information about treatment options is all a patient wanted, Dr Google would have provided a cheaper and more exhaustive consultation, suggests Robson.<\/p>\n<p>Gerd Gigerenzer <a href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g7091\">explores the other side of the equation in an observations column<\/a>. Doctors, he says, often avoid making explicit recommendations. Instead they frame information to lead patients in one direction or another, based on their intuition or preference.<\/p>\n<p>Take the scenario of a patient having to undergo potentially lethal surgery. Gigerenzer suggests that one is more likely to opt for the surgery if the doctor says that 90% of patients are still alive (survival frame) five years after surgery, rather than saying 10% of patients are dead (mortality frame). Although both essentially mean the same thing, and none communicates the chances of survival without surgery altogether, the way information is presented can influence patient choice.<\/p>\n<p>Alongside appreciating these subtleties of risk communication, it is important to step back and examine what drives this information. Clinical recommendations and guidelines often risk distortion being promulgated by experts with financial ties to industry. At <em>The BMJ<\/em>,<a href=\"http:\/\/www.bmj.com\/content\/349\/bmj.g7197\"> we are phasing in a new policy<\/a> to foster independent and unbiased coverage of clinical topics. Starting from next year, we will only pursue clinical education articles written by experts with no financial ties to industry. We hope this move will enhance our readers\u2019 trust in the journal\u2019s content, and are eager to hear your views.<\/p>\n<p><em><strong>Anita Jain<\/strong> is India editor, <\/em>The BMJ<em>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cDoctor, what would you do in my shoes?\u201d This simple plea for advice from a patient may stump many a doctor. Involving patients in decisions about their care is increasingly [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/01\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5749,5750],"tags":[],"class_list":["post-32870","post","type-post","status-publish","format-standard","hentry","category-patient-perspectives","category-the-bmj-today"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The BMJ Today: Unravelling the notion of informed patient choice - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/01\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The BMJ Today: Unravelling the notion of informed patient choice - The BMJ\" \/>\n<meta property=\"og:description\" content=\"\u201cDoctor, what would you do in my shoes?\u201d This simple plea for advice from a patient may stump many a doctor. Involving patients in decisions about their care is increasingly [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2014\/12\/01\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2014-12-01T10:48:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2014-12-02T10:24:14+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2012\/10\/anita_jain.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"The BMJ Today: Unravelling the notion of informed patient choice\",\"datePublished\":\"2014-12-01T10:48:10+00:00\",\"dateModified\":\"2014-12-02T10:24:14+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/\"},\"wordCount\":343,\"commentCount\":1,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2012\\\/10\\\/anita_jain.jpg\",\"articleSection\":[\"Patient and public perspectives\",\"The BMJ today\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/12\\\/01\\\/the-bmj-today-unravelling-the-notion-of-informed-patient-choice\\\/\",\"name\":\"The BMJ Today: Unravelling the notion of informed patient choice - 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