TY - JOUR
T1 - First the facts, then the values? Implicit normativity in evidence-based decision aids for shared decision-making
AU - Molewijk, Bert
AU - Stiggelbout, Anne M.
AU - Otten, Wilma
AU - Dupuis, Heleen M.
AU - Kievit, Job
PY - 2008/1/1
Y1 - 2008/1/1
N2 - This paper focuses on the ethics of constructing and using a specific evidence-based decision aid that aims to contribute to clinical shared decision-making processes. Results of this integrated empirical ethics study demonstrate how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions and values, which pre-structure the moral environment of the shared decision-making process. As a consequence, the evidencebased decision support did not only support the decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy and shared decision-making implying that information disclosure is a conditional requirement before patient autonomy and shared decision-making even starts. The central point of this paper is that decision aids and evidence-based medicine are not value-free and that patient autonomy and shared decision-making are already influenced during the production and presentation of scientific information, Consequences for both the development of decision-aids and the practice of shared decision-making are discussed.
AB - This paper focuses on the ethics of constructing and using a specific evidence-based decision aid that aims to contribute to clinical shared decision-making processes. Results of this integrated empirical ethics study demonstrate how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions and values, which pre-structure the moral environment of the shared decision-making process. As a consequence, the evidencebased decision support did not only support the decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy and shared decision-making implying that information disclosure is a conditional requirement before patient autonomy and shared decision-making even starts. The central point of this paper is that decision aids and evidence-based medicine are not value-free and that patient autonomy and shared decision-making are already influenced during the production and presentation of scientific information, Consequences for both the development of decision-aids and the practice of shared decision-making are discussed.
KW - Decision aids
KW - Empirical ethics
KW - Evidence-based medicine
KW - Implicit normativity
KW - Shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=58149203594&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.zefq.2008.08.014
DO - https://doi.org/10.1016/j.zefq.2008.08.014
M3 - Article
C2 - 19209568
SN - 1865-9217
VL - 102
SP - 415
EP - 420
JO - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
JF - Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
IS - 7
ER -