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KMID : 1025620130160010059
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Korean Journal of Medical Ethics
2013 Volume.16 No. 1 p.59 ~ p.76
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The Practical Model of Medical Decision Making: Interaction with Three Main Forces (Patient-Doctor-Society)
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Lee Hyo-Jean
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Abstract
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Physicians come face to face with many crises concerning the medical decision making. Apart from medical problems, they have to consider patient’s personal needs, social ethics and law. Because physician-patient relationship changed from doctor-centered to cooperation-based like shared decision making. Meanwhile the conflicts between patients and doctors are growing all the time, since each patient has to bear a socioeconomic factors of disease. Therefore, the approach by ethics and law is needed to solve their problem, for example, hospital ethics committee (HEC). In conclusion, the medical decision making process is an outcome from the interaction with three forces: medical opinion of doctor, personal needs of patient and limitation of society like law and ethics. This article shed light on these three main forces and propose practice model. The decision making process of medical opinion model provides the doctors with how to find the problems, and make a plan for diagnostic and therapeutic purposes through hierarchy and sequence. The model of personal needs also guides them through way to narrowing the opinion distance between doctors and patients. And the law and ethics model proposes new concept of HEC, “hierarchical HEC” that is two-step organization for protecting doctors’ decision risk and patients’ interest.
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KEYWORD
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decision making, physician-patient relation, conflict, socioeconomic factors, ethics committees
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