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Appendix: Summary of questions for clinical practice

Published online by Cambridge University Press:  04 May 2010

Alan Schwartz
Affiliation:
University of Illinois, Chicago
George Bergus
Affiliation:
University of Iowa
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Summary

Goals

  • How deeply has my patient considered his/her goals?

  • What does my patient want out of his/her life? What's important?

  • How will treatment options impact my patient's ability to achieve his/her goals?

  • Are there things my patient simply won't do out of strongly held conviction?

Dimensions of health

  • Which dimensions of health are most important to my patient?

  • How fully has my patient considered these dimensions?

  • How do treatment alternatives differ in their impact on each dimension?

Overall health

  • How can my patient best understand an overall health state?

  • How can I help my patient anticipate what a future health state may be like?

  • When do I need to measure or compare utilities for overall health states, and how should I do it?

Quantity and quality of life

  • How will my patients' decisions impact their quality and quantity of life?

  • Are my patients giving too much weight to short-term, transitory outcomes, at the expensive of their long-term health?

  • How can I best illustrate the course of health that my patients can expect?

Uncertainty

  • What are the most important uncertainties in the decision facingmy patient?

  • How does my patient regard risk and uncertainty in his or her life? Does she or he believe in taking chances to achieve big rewards or prefer to opt for smaller but surer results?

  • How can I most effectively and accurately communicate the level of uncertainty associated with a diagnosis, a treatment, or a prognosis to my patient?

  • How can I helpmy patient to cope with their lack of certainty about outcomes or options?

Type
Chapter
Information
Medical Decision Making
A Physician's Guide
, pp. 187 - 190
Publisher: Cambridge University Press
Print publication year: 2008

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