title: A revolution in understanding: how ethics has transformed health care decision making.
abstract: This paper traces the evolution of a new model of health care decision making, from its beginnings in the collapse of "parentalism," through the articulation of the concept of patient autonomy, and perhaps most visibly to the emergence and institutionalization of the idea of patients' rights. Health care professionals no longer uncritically and inappropriately claim access to knowledge of what is right and good for their patients. In the new model, knowledge of the right course of treatment is discovered through sustained dialogue; ultimate authority is exercised by the patient; and responsibility is shared between patient, family, and multiple health care providers. One test of this new model is the extent to which inevitable ethical conflict is acknowledged.
authors.affiliation: Department of the History and Philosophy of Medicine, University of Kansas Medical Center, Kansas City.
authors.forename: W G
authors.initials: WG
authors.lastname: Bartholome
mesh_terms: D003657:Decision Making; D034462:Dissent and Disputes; D026822:Ethicists; D028741:Ethics Committees, Clinical; D004992:Ethics, Medical; D005610:Freedom; D006126:Group Processes; D006801:Humans; D026706:Paternalism; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D010348:Patient Care Team; D028701:Patient Rights; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D012945:Social Values; D016312:Treatment Refusal