Ethical issues and evidence-based patient choice

Abstract

Abstract The concept of ‘evidence-based patient choice’ (EBPC) brings together two important movements in modern medicine. The first of these, ‘evidence-based medicine’, has been described as a ‘paradigm shift’ in medical practice (Hope 1996). It is an approach to medicine based on the claim that clinical interventions are to be justified on the existence of evidence for the effectiveness of the intervention rather than on other grounds such as, for example, the authority of the clinician or of tradition. ‘Patient-centred medicine’ too has arisen out of a concern with and a critical response to traditional medical practice and the traditional overemphasis on the authority of the health care professional. Advocates of patient-centred medicine argue that the best protection for patients from excessive paternalism is to be gained by emphasizing the point that patients should play a central role in decision making about their clinical care. Like evidence-based medicine, patient-centred medicine has been described as marking a fundamental shift in medical practice, a ‘Copernican revolution’ (Battista 1993).