Science, Ethics, and the Making of Clinical Decisions

Abstract

The scientific basis of treatment decisions is analyzed, using controversies about the treatment of mild hypertension to illustrate both the importance and limitations of using data obtained from clinical trials to guide decisions involving risk factor intervention. The ethical aspects of treatment decisions are then considered, with emphasis on the role of patient participation in treatment decisions. It is recommended that, to improve the ability of clinical medicine to apply successfully and ethically the fruits of medical science, further research must be undertaken to understand the full effects of medical diagnoses and treatments; what physicians understand about the risks and benefits of treatment; what patients expect when they consent to the manipulation of risk factors; and how collaborative decision making between physician and patient can be improved. (KIE abstract)