This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Medical Practice  • Medical Ethics  • Patient-Physician Relationship/ Care  • Patient-Physician Communication  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: While I am not a pilot, I am reasonably sure that the likelihood of crashing, as described by Dr Waggoner, is decreased by having a navigator alongside a pilot in the cockpit. The physician, even if a navigator, is still an intimate member of the team. The communication about harm and benefit is improved by the duality. The point of the metaphor was that a physician piloting alone is not the best model of decision making; on this Waggoner and I agree.

The physician can only guide the patient on how to go about choosing; there is no guarantee about what that choice will be. My description of informed choice should not lead to an assumption that understanding trade-offs of harm and benefit in the context of personal values will ensure that choices will be utilitarian. The value to gain or lose is modified by many factors . . . [Full Text of this Article]

Robert A. McNutt, MD
robert_mcnutt@rush.edu
Contributing Editor, JAMA

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Shared Medical Decision Making: Problems, Process, Progress

JAMA. ;292():2516-2518.
FULL TEXT  

Shared Medical Decision Making

JAMA. ;293():1058-1058.
FULL TEXT  

Shared Medical Decision Making
and
JAMA. ;293():1058-1059.
FULL TEXT