Science, Ethics, and the Making of Clinical Decisions: Implications for Risk Factor Intervention

Lachlan Forrow, Steven A. Wartman, Dan W. Brock

Research output: Contribution to journalArticle

Abstract

Recent improvements in the clinical care of individual patients are rooted in advances in two distinct fields of modern medicine: biomedical research and clinical ethics. In this article, we review the differing roles of these two disciplines in guiding decision making for individual patients. Particular attention is placed on decisions involving risk factor intervention, using the common problem of mild hypertension as an illustration. Both the importance and the limitations for decision making of some recently published clinical trials are reviewed. Differences in interpretation of these trials are a source of major disputes about the proper threshold for medical intervention. The ethical aspects of treatment decisions are then reviewed, with particular emphasis on the doctrine of informed consent and on the role of patient participation in treatment decisions. Finally, new directions for clinical research are suggested that may yield a more complete scientific basis for treatment decisions and that may aid in fulfilling the ethical ideals that underlie the physician-patient relationship.

Original languageEnglish (US)
Pages (from-to)3161-3167
Number of pages7
JournalJournal of the American Medical Association
Volume259
Issue number21
DOIs
StatePublished - Jun 3 1988
Externally publishedYes

Fingerprint

Ethics
Decision Making
Clinical Ethics
Research Ethics
Patient Participation
Physician-Patient Relations
Bioethics
Modern 1601-history
Dissent and Disputes
Decision Support Techniques
Informed Consent
Biomedical Research
Patient Care
Therapeutics
Clinical Trials
Hypertension
Research
Clinical Decision-Making
Direction compound

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Science, Ethics, and the Making of Clinical Decisions : Implications for Risk Factor Intervention. / Forrow, Lachlan; Wartman, Steven A.; Brock, Dan W.

In: Journal of the American Medical Association, Vol. 259, No. 21, 03.06.1988, p. 3161-3167.

Research output: Contribution to journalArticle

Forrow, Lachlan ; Wartman, Steven A. ; Brock, Dan W. / Science, Ethics, and the Making of Clinical Decisions : Implications for Risk Factor Intervention. In: Journal of the American Medical Association. 1988 ; Vol. 259, No. 21. pp. 3161-3167.
@article{8f33bbea5a294958b71ac0a5f71503bd,
title = "Science, Ethics, and the Making of Clinical Decisions: Implications for Risk Factor Intervention",
abstract = "Recent improvements in the clinical care of individual patients are rooted in advances in two distinct fields of modern medicine: biomedical research and clinical ethics. In this article, we review the differing roles of these two disciplines in guiding decision making for individual patients. Particular attention is placed on decisions involving risk factor intervention, using the common problem of mild hypertension as an illustration. Both the importance and the limitations for decision making of some recently published clinical trials are reviewed. Differences in interpretation of these trials are a source of major disputes about the proper threshold for medical intervention. The ethical aspects of treatment decisions are then reviewed, with particular emphasis on the doctrine of informed consent and on the role of patient participation in treatment decisions. Finally, new directions for clinical research are suggested that may yield a more complete scientific basis for treatment decisions and that may aid in fulfilling the ethical ideals that underlie the physician-patient relationship.",
author = "Lachlan Forrow and Wartman, {Steven A.} and Brock, {Dan W.}",
year = "1988",
month = "6",
day = "3",
doi = "10.1001/jama.1988.03720210051029",
language = "English (US)",
volume = "259",
pages = "3161--3167",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "21",

}

TY - JOUR

T1 - Science, Ethics, and the Making of Clinical Decisions

T2 - Implications for Risk Factor Intervention

AU - Forrow, Lachlan

AU - Wartman, Steven A.

AU - Brock, Dan W.

PY - 1988/6/3

Y1 - 1988/6/3

N2 - Recent improvements in the clinical care of individual patients are rooted in advances in two distinct fields of modern medicine: biomedical research and clinical ethics. In this article, we review the differing roles of these two disciplines in guiding decision making for individual patients. Particular attention is placed on decisions involving risk factor intervention, using the common problem of mild hypertension as an illustration. Both the importance and the limitations for decision making of some recently published clinical trials are reviewed. Differences in interpretation of these trials are a source of major disputes about the proper threshold for medical intervention. The ethical aspects of treatment decisions are then reviewed, with particular emphasis on the doctrine of informed consent and on the role of patient participation in treatment decisions. Finally, new directions for clinical research are suggested that may yield a more complete scientific basis for treatment decisions and that may aid in fulfilling the ethical ideals that underlie the physician-patient relationship.

AB - Recent improvements in the clinical care of individual patients are rooted in advances in two distinct fields of modern medicine: biomedical research and clinical ethics. In this article, we review the differing roles of these two disciplines in guiding decision making for individual patients. Particular attention is placed on decisions involving risk factor intervention, using the common problem of mild hypertension as an illustration. Both the importance and the limitations for decision making of some recently published clinical trials are reviewed. Differences in interpretation of these trials are a source of major disputes about the proper threshold for medical intervention. The ethical aspects of treatment decisions are then reviewed, with particular emphasis on the doctrine of informed consent and on the role of patient participation in treatment decisions. Finally, new directions for clinical research are suggested that may yield a more complete scientific basis for treatment decisions and that may aid in fulfilling the ethical ideals that underlie the physician-patient relationship.

UR - http://www.scopus.com/inward/record.url?scp=0023889111&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023889111&partnerID=8YFLogxK

U2 - 10.1001/jama.1988.03720210051029

DO - 10.1001/jama.1988.03720210051029

M3 - Article

C2 - 3285047

AN - SCOPUS:0023889111

VL - 259

SP - 3161

EP - 3167

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 21

ER -