Medische besluitvorming bij een levensbedreigende ziekte: de rol van risico-informatie voor de autonomie van de patiënt
12 / 2003 - onbekend
Website Leiden University Medical Center (LUMC)
This multi-center study deals with the ideals and limits of informed consent between patients and surgeons. Central theme is the way surgeons and aneurysm patients define and experience the autonomy of patients in relation with ethical theories about autonomy. We want to know if the disclosure of quantitative individualized risk information (produced by a Markov Decison Analysis Model) empowers the patient to exercise his/her autonomy. What dilemmas exist between patient autonomy and her/his well-being? In a first more psychological pilot, 55 respondents, already treated for an abdominal aneurysm, were presented with individualized risk information concerning surgery and follow-up policy of two hypothetical patients with low respectively high risks on both policies. Risk information included 1 and 5 year mortality risk and life expectancy for the two treatment policies for both hypothetical patients. Information on treatment results and risks were presented in three formats (randomized between respondents): (a) numerical format; (b) graphical format using bars; or (c) graphical format using human figures. In structured interviews respondents were asked to: (1) evaluate the information on 7-point Likert scales (regarding reported difficulty, threat, and relevance); (2) compare the treatment risks in order to test their understanding of the risks; (3) choose between surgery or follow-up.