THE MEDICAL DECISION-MAKING PROCESS AND THE FAMILY: THE CASE OF BREAST CANCER PATIENTS AND THEIR HUSBANDS

Authors: GILBAR, ROY¹; GILBAR, ORA²

Source: Bioethics, Volume 23, Number 3, March 2009 , pp. 183-192(10)

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Abstract:

Objectives:

The objectives of the study were (1) to assess similarities and differences between breast cancer patients and their husbands in terms of doctor-patient/spouse relationships and shared decision making; and (2) to investigate the association between breast cancer patients and husbands in terms of preference of type of doctor, doctor-patient relationship, and shared decision making regarding medical treatment. Method:

Fifty-seven women with breast cancer, and their husbands, completed questionnaires measuring doctor-patient/spouse relationships (paternalism, autonomy), and decision making regarding medical treatment. Results:

Patients believe they have a key role in the medical decision-making process (93%) and that the participation of their husbands, and their agreement with the decision, is important (84% and 89%, respectively). Both breast cancer patients and their husbands prefer a shared decision-making process to paternalistic or autonomy-based approaches. Conclusion:

In contrast to legal and bioethical approaches, which focus on the patient as the primary decision maker, this study reflects a practical recognition of the role of the breast cancer patient's husband in the decision-making process. It also reflects a relational rather than an individualistic perception of patient autonomy.

Keywords: breast cancer patients; husband; decision making; doctor-patient/husband relationships; patient autonomy; paternalism

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1467-8519.2008.00650.x

Affiliations: 1: School of Law, Netanya Academic College, Israel 2: School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel

Publication date: 2009-03-01