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Schipper, H.S.

Author: Henk Schipper
Graduation Year: 2008
Department: Practical Philosophy

Thesis:
Genetic Screening and Patient Autonomy. The theory and practice of informed decision making.

 

Summary:

Informed decision making is generally considered as an important instrument to realize patient autonomy in the medical practice. In this master’s thesis, patients’ informed decision making in a specific medical practice is investigated, wondering: Are patients able to make informed decisions in genetic screening situations?

In order to make an informed decision, two criteria have to be satisfied. First, patients must have the capacity to weigh the advantages and disadvantages of the relevant possible courses of action, and to decide whether these courses of action accord with their values: the ‘reasonable individual’ criterion. Second, patients have to make a choice based on sufficient, good quality information about the advantages and disadvantages of the relevant possible courses of action, and have to do so in accordance with their values: the ‘reasonable choice’ criterion.

With respect to the ‘reasonable individual’ criterion, this master’s thesis shows that framing effects and the use of decision heuristics bias patients’ risk perceptions and decision making in genetic screening situations. Thereby, patients’ ability to make informed decisions in genetic screening situations is fundamentally compromised. With respect to the ‘reasonable choice’ criterion, this master’s thesis reports both shortcomings in the information supply and nondirectiveness of genetic counselors.

In short, this master’s thesis reveals serious infringements of patients’ informed decision making in genetic screening situations, is meant to raise awareness of the involved problems, and calls for directed research and interventions to improve patients’ informed decision making in genetic screening situations.

 

Last modified:01 November 2013 2.50 p.m.