Patients' Participating in Decision-Making - Essay Example

Patients' Participating In Decision-Making Towards Their Treatment Abstract Before the passage of the Bipartisan Patient Protection Act, doctors used to have an ethical duty to discuss with their patients matters regarding their treatment. This however is not the case as will be discussed in this paper. With the passage of the Act, doctors now have an ethical and legal duty to consult their patients before charting out a course of treatment. This research discusses what patients should expect now that treatment decisions have to be communicated. Patients will enjoy protection from medical insurers and not have their treatment course varied arbitrary. Individual patient’s requirements will also be taken into account before doctors can recommend a course of treatment and patients may start enjoying autonomy with regard to courses of treatment. The common practice when it comes to treatment decisions in the US and also other parts of the world is for the doctors to choose for the patients a treatment course they will undergo. As Haber (2010) points out, the priority of the doctor is what in most instances will determine the course of treatment to be followed. The Bipartisan Patient Protection Act which is informally known as the patient’s bill of rights is a law meant to protect Americans with regard to health care plans. One of the tenets enshrined in this law is the need for doctor-patient consultation before deciding a course of treatment. Rodin and Langer (1977) in their study have seen the benefit to patients on being involved in decision making. They observed greater sociability and mental health to patients who had been involved in decision making. This research paper will focus on patients need to understand the treatment decision they have chosen. While discussing this aspect, focus will be on the treatment decision with regard to medical insurance providers, treatment course based on the information provided, treatment decisions with regard to potential side effects to the patient, and choice of stopping treatment or changing hospitals. This right recognizes that on issues touching on patient’s treatment and care, all patients have the responsibility and right to take part in making an appropriate decision. In a situation where a patient is not in a position to exercise this right, a family member or a representative who is authorized can act on the patient’s behalf. It is imperative that patients know the course of treatment they will have to take because this will assist them fully in understanding what their Health Managed Organization (HMO) will cover. The Act assures patients that the medical treatment that they choose will not be interfered with by the medical insurers (Feinstein, 2001). This was done after doctors complained that insurers sought to change patient’s treatment plans to their detriment. The Act now safeguards patient’s rights. A patient who is covered by an insurance company cannot have their treatment course varied arbitrarily. The patient bill of rights having mandated the consultation of patients in decision making enables patients to choose a course of treatment they feel comfortable with (American health association, 1992). The consultation by medical personnel should cover explanation on the available courses of treatment, the risk involved with each treatment, likelihood of success of each course of treatment, any alternatives that may be available and general information about their treatment (Guadagnoli and Ward, 1998). Protheroe et al. (2000) found out that when a patient understood one treatment course, in some instances they eliminated prescribed medication due to the fact that the patient found it not beneficial to their overall wellbeing. In their research they found out that where patients comprehended the course of treatment, a favorable result could be for the patients. Patients input could result in situations where a standard course of treatment is abandoned. Medications primary aim is to cure an ailment or manage it to a level the patient can be comfortable. However, most of the prescribed medications usually have side effects which in some instances can be as worse as the actual ailment. Consequently, patients are seen to suffer from side effects which if given a choice could have opted not to endure. By a patient understanding the course of treatment they have chosen, they stand a better chance to know potential side effects that may follow from their choice of treatment. Haber (2010) points to the fact that patients will make informed decisions knowing that they can bear the side effects of one course of treatment than another. Understanding ones decision emanating from a given course of treatment allows planning by patients who have to take multiple sets of medications (Haber, 2010). By understandings ones treatment decision, a patient has the option of abandoning a course of treatment already started. However, this should be to the extent allowed by law and hospital policy because as Degner and Sloan (1992) point out, certain limitations need to be put to this rule to safeguard the patient’s health. The patient can further request for an alternative course of treatment and if the same is not provided in that hospital, the patient can ask for a transfer to a hospital where those services can be provided. In instances of transferring, the patient is to be communicated to any risk or advantage emanating from such a transfer. The aim for these rights is to give patients the care and treatments that will generally suit them. It should be noted that even though doctors are legally obliged to inform their patient and make them understand the treatment that will be undertaken, not all patients will want to know how a decision on their course of treatment was reached. Coulter (1997) shows that patients are unwilling to take part in the consultative process, leaving it to the physicians because they know best. Robinson and Thomson (2001) concur with these sentiments by stating some patients prefer to defer medical decisions to their doctors. However, in some situations patients may choose to defer to the physician because at a particular point the doctor’s explanation is usually complex (Wirtz, Cribb, and Barber, 2006). Coward and Rattnakun (1999) highlight another point that patients trust their doctors and have faith in their expertise. For this reason, they may opt not to participate in the treatment decision. Heritage and Maynard (2006) have argued that the apparent passivity of some patients is because they are usually waiting to be explicitly invited to take part in consultations. To conclude, it is important to reiterate the importance of patients understanding their treatment plans. As discussed, by participating in the decision making process, patients are able to forward their input which when combined with the doctor’s medical opinion, a decision can be reached which will be accommodative to the patients treatment needs as well as overall wellbeing. It should also be pointed out that the patient’s bill of rights also serves to protect the patient’s interest from greedy medical insurance firms who usually compromise patient’s treatment plans to save costs. In the discussion it was noted that although this tenet is enshrined in our laws, some doctors may opt not to follow it due to their patient’s reluctance to indulge in medical discussions. When such situations arise, doctors should still insist on explaining treatment decisions and if possible, in a simplistic manner in order to make patients understand the treatment. References American Hospital Association, (1992). A patient’s bill of rights. Retrieved from, . Coward, H.G., and Rattnakun, P. (1999). A cross-cultural dialogue on health care ethics. Coward,H.G., and Rattnakun, P. (Ed.). Waterloo, Ontario: Wilfrid Laurier University Press. Coulter, A. (1997). Partnerships with patients: the pros and cons of shared clinical decision making. National Centre for Biotechnology Information, 2(2), 112-21. Degner L. F., and Sloan J. A. (1992) Decision making during serious illness: What role do patients really want to play? Clin Epidemol, 45, 941-50. Feinstein, D. (2001). U.S. senate approves patient’s bill of rights. Retrieved from . Glasziou, P. P. and Irwig, L. M. (1995). An evidence based approach to individualizing treatment. British Medical Journal, 311(7016), 1356–1359. 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Long-term effects of a control-relevant intervention with the institutionalized aged. Journal of Personality and Social Psychology, 35, 897-902. Wirtz, V., Cribb, A., and Barber, N. (2006). Patient-doctor decision-making about treatment within the consultation: A critical analysis of models, ScienceDirect, 62(1), 116-124. Read More