Disclosure and rationality: comparative risk information and decision-making about prevention.
With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients "comparative risk information," such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the "personal risk"), the risk reduction the treatment provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine.
Schwartz
Peter H
PH
Indiana University Center for Bioethics, Indiana University School of Medicine, Indiana University-Purdue University, Indianapolis (IUPUI), 410 W. 10th St., Suite 3100, Indianapolis, IN 46202, USA. phschwar@iupui.edu
D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects; D001290:Attitude; D001943:Breast Neoplasms / Q000517:prevention & control; D003657:Decision Making; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011322:Primary Prevention; D012306:Risk; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects; D014342:Truth Disclosure
D018931:Antineoplastic Agents, Hormonal; D020847:Estrogen Receptor Modulators; D013629:Tamoxifen