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A Prospective Study

Jennifer Susan Mark; Howard Spiro, MD

Arch Intern Med. 1990;150(4):777-780.

Abstract
• Central to the nature of the physician-patient relationship is how fully patients are informed about their disease and prognosis and how active a role they take in deciding treatment; the "autonomy" and "paternalistic" models represent current poles of physician behavior. While informed consent has become ubiquitous in medical practice, it is not clear to what extent the value of patient autonomy has entered into everyday medical decisions. To evaluate informed consent, we prospectively surveyed 102 outpatients scheduled to undergo a colonoscopy and 16 of their physicians. The colonoscopy examination is straightforward and offers an optimal opportunity for patient participation in decision making. We found that most patients wanted guidance from their physicians and most physicians did not view the patient as autonomous. The more traditional parentalistic model continues to influence the physician-patient relationship, at least for this technical endeavor.

(Arch Intern Med. 1990;150:777-780)

Author Affiliations
From the Program for Humanities in Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn.

Footnotes
Accepted for publication December 22,1989.

Reprint requests to the Program for Humanities in Medicine, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 (Dr Spiro).

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