title: The medical decision-making process and the family: the case of breast cancer patients and their husbands.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Law, Netanya Academic College, 1 University Street, Netanya 42365, Israel. gilbroi@netanya.ac.il
authors.forename: Roy
authors.initials: R
authors.lastname: Gilbar
authors.forename: Ora
authors.initials: O
authors.lastname: Gilbar
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D004522:Educational Status; D005195:Family Relations; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D026706:Paternalism; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D018454:Spouses; D011795:Surveys and Questionnaires