These conclusions come from a study by researchers from the Faculty of Medicine of the University of Porto (FMUP) and CINTESIS – Center for Research in Health Technologies and Services.
The team, coordinated by Carlos Martins (FMUP/CINTESIS), assessed 599 Portuguese between 20 and 99 years of age (average of 51.9 years), in a representative sample of the national population.
The objective was to understand to what extent the Portuguese want to be involved in the medical decision-making process.
The results surprised the researchers due to the small proportion of Portuguese people who, faced with different types of clinical situations, consider that the decision should be shared between doctor and patient.
“The vast majority of patients prefer that the doctor takes control of problem solving and decision-making, whether in terms of quality of life or in life-threatening illnesses or clinical situations. Portuguese patients prefer a passive role and want the doctor to decide”, say the authors.
Faced with a life-threatening clinical situation, 66.1% of Portuguese respondents believe that the decision should be made by the doctor, with patients assuming a passive role.
In a situation of non-life-threatening illness, 64.4% consider that the decision should be made by the doctor, and in a situation of quality of life, 55.4% of the Portuguese consider that the decision should also be made by the doctor.
The researchers also found that taking an active role and sharing decisions with the doctor was more accepted in younger, more educated and employed people.
According to Carlos Martins, this is a sign of evolution “in the way decisions are made during medical consultations. More and more, pedagogically and scientifically, we have been investing in a patient-centered consultation, based on a model of shared medical decision-making, instead of the paternalistic consultation model in which the decision-making power rests entirely with the doctor”.
For the authors, this study further reinforces the importance of “training physicians to adequately involve patients in decision-making, in a shared way”.
“The shared medical decision is not the simple act of a doctor, empathically, sharing his decision with the patient. The shared medical decision involves much more than that, it implies training the patient, so that he perceives the benefits and risks of treatment A and also of treatment B, to decide, together, the therapeutic option”.