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Durham Research Online
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Selecting treatment options and choosing between them : delineating patient and professional autonomy in shared decision-making.

Emma, Cave (2020) 'Selecting treatment options and choosing between them : delineating patient and professional autonomy in shared decision-making.', Health Care Analysis, 28 . pp. 4-24.

Abstract

Professional control in the selection of treatment or investigatory options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies that have potential to elevate the importance of patient and family preferences. In combination, they may be perceived by healthcare professionals as an obligation to follow patient preferences, even where doing so conflicts with other professional obligations. It is argued that a more nuanced approach to shared decision-making could help clarify the boundaries of decision-making responsibility.

Item Type:Article
Full text:Publisher-imposed embargo
(AM) Accepted Manuscript
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Available under License - Creative Commons Attribution.
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Full text:(VoR) Version of Record
Available under License - Creative Commons Attribution.
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(629Kb)
Status:Peer-reviewed
Publisher Web site:https://doi.org/10.1007/s10728-019-00384-8
Publisher statement:This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Date accepted:29 August 2019
Date deposited:02 September 2019
Date of first online publication:21 September 2019
Date first made open access:25 September 2019

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