PREFERENCE OF PATIENTSPREFERENCE OF PATIENTS

DATO’ AHMAD TAJUDDIN JAAFARDATO’ AHMAD TAJUDDIN JAAFARDEANDEAN

MEDICAL & ALLIED HEALTH SCIENCEMEDICAL & ALLIED HEALTH SCIENCEALLIANZE COLLEGE OF MEDICAL SCIENCESALLIANZE COLLEGE OF MEDICAL SCIENCES

PREFERENCE OF PATIENTSPREFERENCE OF PATIENTS

Patient preference means the choices that persons make when they are faced with decisions about health and medical treatment.

Choices made by patients based on:-

- Information provided by a physician

- patients’ own experience, beliefs and

values.

When there are medical indication for treatment, a physician should propose a treatment plan that a patient may accept of refuse.

An informed, competent patients preference to accept or refuse medically indicated treatment has clinical, ethical, legal and psychological importance

Patient preferences are the ethical and legal nucleus of a patient-physician relationship.

CLINICAL SIGNIFICANCE OF CLINICAL SIGNIFICANCE OF PATIENT PREFERENCEPATIENT PREFERENCE

Patient preference are essential to good clinical care because patients’ cooperation and satisfaction reflect the degree to which medical intervention fulfills the patients’ choices, values and needs.

Patients who collaborates with their physicians to reach a shared health care decision have greater trust in the doctor-patient relationship..(cont.)

.. (Cont.)

cooperate more fully to implement the shared decision, and express greater satisfaction with their health care.

Research has shown that patients with chronic diseases enjoy better health outcomes when they ask questions, express opinions, and make their preferences known..(cont.)

.. .. (cont.)

when their physicians have a ‘participatory’ rather than a ‘controlling’ decision making style.

A participatory style is associated with primary care training, skill in interviewing that facilitates emphatic listening and communication, and the opportunity to take time with patients.

This approach is referred to as ‘patient-centered medicine’.

Documentation of the patients’ informed consent also serves as a defense for the physician against a claim that their patient was coerced.

Apart from clinical skill and carefulness, a respect for patient preferences, good communication and a participatory style of dealing with patients appear to be the most effective protection that physicians have against malpractice lawsuits.

PSYCHOLOGICAL SIGNIFICANCE OF PSYCHOLOGICAL SIGNIFICANCE OF PATIENT PREFERENCE : CONTROLPATIENT PREFERENCE : CONTROL

Patient preference are psychologically Patient preference are psychologically significant because the ability to express significant because the ability to express preferences and have others respect them preferences and have others respect them is crucial to a sense of personal worth.is crucial to a sense of personal worth.

When patient preference are ignored or When patient preference are ignored or devalued, patients are likely to distrust and devalued, patients are likely to distrust and perhaps disregard physician's perhaps disregard physician's recommendationrecommendation

When patients are overtly or covertly When patients are overtly or covertly uncooperative, the effectiveness of the uncooperative, the effectiveness of the therapy is threatened.therapy is threatened.

Patient preference are important because Patient preference are important because their expression may lead to informed their expression may lead to informed consentconsent

ETHICAL SIGNIFICANCE OF ETHICAL SIGNIFICANCE OF PATIENT PREFERENCEPATIENT PREFERENCE

1.1. AUTONOMYAUTONOMY

Patient preference are ethically significant because they manifest the value of personal autonomy

The recognition of patient preference The recognition of patient preference respects the value of personal autonomy respects the value of personal autonomy in medical care.in medical care.

LEGAL SIGNIFICANCE OF PATIENT LEGAL SIGNIFICANCE OF PATIENT PREFERENCEPREFERENCE

Patient preference are legally significant Patient preference are legally significant because the law recognizes that all because the law recognizes that all persons have a a fundamental right to persons have a a fundamental right to control their own body, and the right to be control their own body, and the right to be protected from unwanted intrusions or ‘ protected from unwanted intrusions or ‘ unconsented touchings’unconsented touchings’

The legal requirement of explicit consent The legal requirement of explicit consent before specific treatment protects the legal before specific treatment protects the legal right of patients to control what is done to right of patients to control what is done to their own bodies.their own bodies.

To the discovery of other factors, such as To the discovery of other factors, such as fears, fantasies, or unusual beliefs, that fears, fantasies, or unusual beliefs, that the physician should consider in dealing the physician should consider in dealing with the patients.with the patients.