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The most popular current models of medical decision making, identified by names such as shared decision making, informed decision making, and evidence-based patient choice, portray an empowered patient actively involved in his or her medical choices and generally assume that patient and physician reach agreement. These models are limited to a specific type(More)
CONTEXT Routine cancer screening with prostate-specific antigen (PSA) is controversial, and practice guidelines recommend that men be counseled about its risks and benefits. OBJECTIVE To evaluate the process of decision making as men react to and use information after PSA counseling. DESIGN Written surveys and semistructured qualitative interviews(More)
We undertook a qualitative e-mail survey of federally-funded principal investigators of their views of the US human subjects protection system, intended to identify the range of investigator attitudes. This was an exploratory study with a 14% response rate. Twenty-eight principal investigators responded; their comments were analyzed to show underlying(More)
The law of bioethics has been the law of cases. Interpreting the common law and the Constitution, judges have written the law of informed consent, abortion, and assisted suicide. Reacting to causes célèbres, legislatures have written the law of advance directives and end of life decisions. The long, sad death of Terri Schiavo eclipsed even the long, sad(More)
To the Editor—The statement by the Infectious Diseases Society of America (IDSA) [1] is the keenest analysis of the institutional review board (IRB) system ever published in a medical journal. It describes a regulatory regime swamped with pointless paperwork (eg, the Health Insurance Portability and Accountability Act [HIPAA]), multiple IRBs making(More)