Making Medical Decisions: An Approach to Clinical Decision Making for Practicing Physicians

1999 ◽  
Vol 74 (8) ◽  
pp. 849
Author(s):  
John B. Bundrick
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Medical Decisions ◽  
Practicing Physicians

scholarly journals Complexity of Clinical Decision Making: Consent, Capacity, and Ethics

2019 ◽  
Vol 40 (03) ◽  
pp. 162-169 ◽  
Author(s):  
Annette Askren ◽  
Paula Leslie
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Negative Charge ◽  
Clinical Decision ◽  
Informed Consent Process ◽  
Thickened Liquids ◽  
Medical Decisions ◽  
Social Media Platforms ◽  
The Right ◽  
Right To Refuse

AbstractSpeech–language pathologists (SLPs), and really their patients, are often faced with challenging clinical decisions to be made. Patients may decline interventions recommended by the SLP and are often inappropriately labeled “noncompliant.” The inappropriateness of this label extends beyond the negative charge; the patient's right to refuse is, in fact, protected by law. Anecdotal exchanges, social media platforms, and American Speech-Language-Hearing Association forums have recently revealed that many SLPs are struggling with the patient's right to decline. Many are not comfortable with the informed consent process and what entails patients' capacity to make their own medical decisions. Here, we discuss the basics of clinical decision-making ethics with intent to minimize the clinician's discomfort with the right to refuse those thickened liquids and eliminate the practice of defensive medicine.

scholarly journals Measuring veterinary client preferences for autonomy and information when making medical decisions for their pets

2021 ◽  
pp. 1-10
Author(s):  
Holli H. Seitz ◽  
Jesse G. Grady
Keyword(s):  
Decision Making ◽  
Pilot Study ◽  
Clinical Decision Making ◽  
Small Animal ◽  
Clinical Decision ◽  
Community Practice ◽  
Medical Decisions ◽  
Preference Index ◽  
Pet Owner ◽  
Autonomy Preference Index

Abstract OBJECTIVE To adapt the 3 scales of the Autonomy Preference Index to veterinary medicine and validate the 3 new scales to measure pet owner preferences for autonomy and information when making medical decisions for their pets. SAMPLE 10 small-animal veterinarians and 10 small-animal clients at a veterinary school–based community practice (pilot study) and 311 small-animal clients of the practice (validation study), of which 47 participated in a follow-up survey. PROCEDURES Wording of items in the Autonomy Preference Index was adapted, and instrument wording was finalized on the basis of feedback obtained in the pilot study to create 3 scales: the Veterinary General Decision-Making Preferences Scale (VGDMPS), Veterinary Clinical Decision-Making Preferences Scale (VCDMPS), and Veterinary Information-Seeking Preferences Scale (VISPS). The 3 scales were then validated by means of administering them to small-animal clients in a clinical setting. RESULTS The 3 scales had acceptable reliability and validity, but clients expressed concern over item wording in the VGDMPS during the pilot study. Overall, results showed that clients had a very high preference for information (mean ± SD VISPS score, 4.78 ± 0.36 on a scale from 1 to 5). Preferences for autonomy varied, but mean values reflected a low-to-moderate desire for autonomy in clinical decision-making (mean ± SD VCDMPS score, 2.04 ± 0.62 on a scale from 1 to 5). CONCLUSIONS AND CLINICAL RELEVANCE The VCDMPS was a reliable and valid instrument for measuring client preferences for autonomy in clinical decision-making. Veterinarians could potentially use this instrument to better understand pet owner preferences and tailor their communication approach accordingly.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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