Cultures That Over-Prioritize Patient Autonomy Influence Physician Trainee Decision Making

May 6, 2015 | Strategic Insights for Health System


A hospital's prioritization of patient autonomy versus what is in a patient's best interest appears to influence the way that physician trainees conceptualize patient autonomy as well as the degree of choice and recommendations they were willing to offer regarding do-not-resuscitate decision making, according to the results of a study published in the May 2015 issue of JAMA Internal Medicine. The study, which evaluated the interviews of 58 internal medicine physicians from four academic medical centers from March 7, 2013, through January 8, 2014, found that trainees at organizations where the policies and culture prioritized autonomy-focused attitudes exhibited an unreflective deference to autonomy, and many seemed compelled to offer the choice of resuscitation neutrally in all situations regardless of whether they felt it was clinically appropriate.

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