title: Prudent evidence-fettered shared decision making.
abstract: In its brief tenure evidence-based medicine (EBM) has proven to be a powerful magnet for criticism, while at the same time it has demonstrated impressive resilience. Located within the ongoing critical discourse surrounding the strengths and weaknesses of an EBM approach is the persistent question of the proper place of the social sciences relative to other disciplinary perspectives. This article considers one way the social sciences might usefully illuminate EBM-mediated human interactions to influence policy. We focus on the ethical nexus of the human impulse for unlimited consumption of health care resources in those situations where there exist competing clinical management options and suggest strategies for resource-preserving shared decision making. We conclude that a frugal default option is a fruitful avenue for future exploration in such situations.
authors.affiliation: Center for Ethics and Humanities in the Life Sciences, Michigan State University, East Lansing, Michigan 48824, USA. libby.bogdan@ht.msu.edu
authors.forename: Elizabeth Libby
authors.initials: EL
authors.lastname: Bogdan-Lovis
authors.forename: Margaret
authors.initials: M
authors.lastname: Holmes-Rovner
mesh_terms: D001519:Behavior; D003657:Decision Making; D019317:Evidence-Based Medicine; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D010358:Patient Participation; D026684:Personal Autonomy; D011320:Primary Health Care; D012942:Social Sciences