Abstract

Progress in medical science and technology during the previous hundred years has opened up new possibilities in the diagnostics and treatment of many medical conditions. Unfortunately, not all diseases can be cured; in many cases medicine can help the patient live with his or her disease, to adapt to everyday life and even work. Paternalism is gradually receding in the doctor-patient relationship. Owing to modern technology, patients have access to medical information as well as their own medical data. Very often they have adequate information about their illness; they ask many questions from the doctor and expect a high level of competence from him/her. In recent decades a new paradigm—evidence-based medicine—has emerged. It is based on the tenet that decision-making in case of different medical conditions should be based on evidence drawn from well-designed and well-conducted research. Guidelines for medical practice are also compiled by using evidence. In everyday medical practice it is sometimes impossible to handle a patient only on the basis of evidence. The patient may have concurrent medical problems and even the best designed research may be unhelpful in such cases. The further development of evidence-based medicine is only possible in cooperation with the patient, through sharing decision-making with him or her. The principles of shared decision-making, patient-centred care and medical consumerism are based on informing the patient, considering his/her preferences and individual needs. The doctor and the patient should be equal partners in making the best decision for the patient.

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