title: The professional medical ethics model of decision making under conditions of clinical uncertainty.
abstract: The professional medical ethics model of decision making may be applied to decisions clinicians and patients make under the conditions of clinical uncertainty that exist when evidence is low or very low. This model uses the ethical concepts of medicine as a profession, the professional virtues of integrity and candor and the patient's virtue of prudence, the moral management of medical uncertainty, and trial of intervention. These features combine to justifiably constrain clinicians' and patients' autonomy with the goal of preventing nondeliberative decisions of patients and clinicians. To prevent biased recommendations by the clinician that promote such nondeliberative decisions, medically reasonable alternatives supported by low or very low evidence should be offered but not recommended. The professional medical ethics model of decision making aims to improve the quality of decisions by reducing the unacceptable variation that can result from nondeliberative decision making by patients and clinicians when evidence is low or very low.
authors.affiliation: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030-3411, USA. laurence.mccullough@bcm.edu
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
mesh_terms: D003657:Decision Making / Q000941:ethics*; D019317:Evidence-Based Medicine / Q000941:ethics / Q000379:methods / Q000592:standards; D006801:Humans; D008962:Models, Theoretical; D010819:Physician's Role; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000941:ethics; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D035501:Uncertainty