Risk Management and Consumer Participation in Medical Decision Making

The concept of consumer sovereignty has had little application in medical decision making. Differences between physicians and patients on the values associated with different courses of medical action are to be expected. The physician would benefit from greater knowledge of the attitudes of the patient toward possible outcomes of different courses of treatment and toward the associated risks. Our purpose is to suggest a research scheme to investigate choices involving risk in medical decision making and to identify those factors and strategies which may improve the quality of consumers' participation in medical decisions. Medical risk decision situations are defined as circumstances in which alternative courses of treatment are associated with sets of possible outcomes, each of which occurs with known probability. To obtain this information a panel of expert physicians will be consulted. Consumers differ greatly in their willingness to accept risk, and they differ in the value which they associate with specific outcomes. Their attitudes can be determined through survey techniques. A series of interlocking research efforts is recommended for this study. This research involves medical students, consumers, and physicians to examine the normative and behavioral aspects of medical decision making under risk. Implementation of the results will require the efforts of public health authorities. The results of the aforementioned efforts can be used to develop educational games and simulations for medical students to increase their responsiveness to consumers' preferences. Another objective of the research described is to develop decision making aids so that practicing physicians can use the empirical results of such studies.