title: Final responsibility for treatment choice: the proper role of medical doctors?
abstract: OBJECTIVE
  To analyse whether the traditional allocation of decision-making responsibility is still justifiable. And, if not to analyse the strength of claims made by other health care professions and by patients.
  
  
  BACKGROUND
  Traditionally doctors have been responsible for choices of treatment, both in terms of deciding and in terms of taking responsibility for the decisions. But modern health care work often takes place in teams involving health care professionals from different professions as well as the patient. In such teams it may not be obvious who should be responsible for treatment choice.
  
  
  METHODS
  Philosophical analysis of epistemic, ethical and organizational arguments, including analysis of the historical origins of these arguments.
  
  
  RESULTS
  The epistemic, ethical and organizational arguments for maintaining a primary decision making role for doctors are not sound. Other health care professionals can, in some circumstances make stronger and more justified claims. The arguments against allocation decision making authority to patients are also invalid or unsound in many circumstances.
  
  
  CONCLUSIONS
  There are many situations in which final responsibility for treatment choice should rest with health care professionals who are not doctors and with patients.
authors.affiliation: Centre for Social Ethics and Policy, School of Law Manchester, University of Manchester, Manchester, UK. soren.holm@manchester.ac.uk
authors.forename: Søren
authors.initials: S
authors.lastname: Holm
mesh_terms: D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D019359:Knowledge; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation; D026684:Personal Autonomy; D010819:Physician's Role; D010817:Physician-Patient Relations; D017009:Professional Autonomy; D012922:Social Change; D013812:Therapeutics / Q000523:psychology