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Cited by 55Healthcare Decision-Making and RestraintsEthics and bioethics in healthcareEthics in medical practice

Physicians’ personal values in determining medical decision-making capacity: a survey study

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Hermann, Helena, Trachsel, Manuel, Biller-Andorno, Nikola·2015·Journal of Medical Ethics
DOI 10.1136/medethics-2014-102263
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Abstract

Decision-making capacity (DMC) evaluations are complex clinical judgements with important ethical implications for patients' self-determination. They are achieved not only on descriptive grounds but are inherently normative and, therefore, dependent on the values held by those involved in the DMC evaluation. To date, the issue of whether and how physicians' personal values relate to DMC evaluation has never been empirically investigated. The present survey study aimed to investigate this question by exploring the relationship between physicians' value profiles and the use of risk-relative standards in capacity evaluations. The findings indicate that physicians' personal values are of some significance in this regard. Those physicians with relatively high scores on the value types of achievement, power-resource, face and conformity to interpersonal standards were more likely to apply risk-relative criteria in a range of situations, using more stringent assessment standards when interventions were riskier. By contrast, those physicians who strongly emphasise hedonism, conformity to rules and universalism concern were more likely to apply equal standards regardless of the consequences of a decision. Furthermore, it has been shown that around a quarter of all respondents do not appreciate that their values impact on their DMC evaluations, highlighting a need to better sensitise physicians in this regard. The implications of these findings are discussed, especially in terms of the moral status of the potential and almost unavoidable influence of physicians' values.

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  • Research has also shown that the assessing physicians' own personal values and opinions may bias their judgments of a patient's mental capacity.

    “Research has also shown that the assessing physicians’ own personal values and opinions may bias their judgments of a patient’s mental capacity (51).”

    From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [51]

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Authors
Hermann, H., Trachsel, M., & Biller-Andorno, N.
Affiliations
University of Zurich (CH)
ORCID
Trachsel, Manuel
Venue
Journal of Medical Ethics
Publisher
BMJ
Published
2015-03-17
Volume
41
Issue
9
Pages
739-744
ISSN
  • 0306-6800 (ISSN-L)
  • 1473-4257
DOI
10.1136/medethics-2014-102263
OpenAlex
W2152916247
Cited by
55
References
18
Citations by year
2025: 2 · 2024: 9 · 2023: 2 · 2022: 10 · 2021: 3 · 2020: 8 · 2019: 3 · 2018: 8 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 1
FWCI
7.03
Type
journal article
Language
en
Open access
Locations
  • Journal of Medical Ethics (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
Keywords
decision-making capacity, capacity assessment, patient autonomy, value profiles, utilitarianism, hedonism, universalism, clinical judgment
MeSH terms
Clinical Decision-Making, Adult, Attitude of Health Personnel, Decision Making, Female, Humans, Judgment, Male, Middle Aged, Physician-Patient Relations, Physicians, Health Care Surveys, Personal Autonomy

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