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Five dimensions of clinical care that should be understood by patients

Posted by plosmedicine on 31 Mar 2009 at 00:17 GMT

Author: Iain Chalmers
Position: Editor, James Lind Library
Institution: James Lind Initiative
Submitted Date: December 07, 2007
Published Date: December 10, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Dimension 1: There is a widespread therapeutic misconception that clinical care offered by health professionals to patients can be assumed to be more likely to do good than harm.

Dimension 2: Patients should be aware that there is substantial evidence that inadequately evaluated and widely adopted clinical care has caused suffering and death of patients on a massive scale.

Dimension 3: Patients have a right to expect reliable information about what is and is not known about the effects of the care being offered to them.

Dimension 4: Patients should understand that, when there is uncertainty about the effects of clinical care, some health professionals believe that they have a duty, both to their current and to their future patients, to confront this uncertainty in rigorous treatment evaluations.

Dimension 5: If treatments are being offered in the context of such evaluations, patients should understand that more tests may be used than is usual in clinical care.

Competing interests declared: I declare that, as a patient, I have a vested interest in uncertainties about the effects of clinical care being acknowledged and addressed.