Patient responsibility for medical decision making and risky treatment options.
OBJECTIVE
Studies have shown that increasing patient participation in decision making decreases utilization of risky procedures. It has been demonstrated that risk perception is increased under conditions that emphasize volition, or the act of choosing. The objective of this study was to examine whether emphasizing volition increases patients' risk perception and decreases their willingness to accept risk.


METHODS
Consecutive patients attending outpatient clinic appointments viewed a video in which a physician described the availability of a new medication associated with a rare risk of a serious side effect. Patients' willingness to accept treatment and worry about the risk of the serious side effect were measured under 2 different conditions: one that minimized patient involvement and the one that maximized patient involvement in the decision-making process.


RESULTS
The willingness of the subject to take the proposed medication was lower (mean +/- SD 4.2 +/- 3.7 versus 5.3 +/- 3.7; P < 0.001) and their worry about the risk of the adverse event was greater in the high compared with the low involvement condition (mean +/- SD 6.1 +/- 3.7 versus 5.5 +/- 3.8; P < 0.001).


CONCLUSIONS
Increasing patient responsibility in medical decision making may decrease the patient's willingness to accept risky treatment options.
Fraenkel
Liana
L
Yale University School of Medicine, New Haven, Connecticut, USA. liana.fraenkel@yale.edu
Peters
Ellen
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D030881:Disclosure; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D018570:Risk Assessment; D012307:Risk Factors; D014741:Video Recording; D055815:Young Adult