UBC Theses and Dissertations

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UBC Theses and Dissertations

Patient participation in the decision to treat coronary artery disease Fulton, Marian Jane


This study was based on the normative argument that patients ought to participate in treatment decisions that could influence the length and quality of their lives. Efforts were made to explore potential errors of judgement that could interfere with the expression of a true preference by a patient. The results of this exploration suggested that people in real decision making situations are affected by framing, they make inconsistent choices, they reverse preferences in situations where preferences are expressed by bids versus choices, and their choices change in situations of potential gain and potential loss. Participants in the study were willing to pay for an improved position on a waiting list for treatment, but they were very reluctant to sell or trade such a position. An analysis of patients' age and exposure to the health system demonstrated that age was not a predictor of patient choices while pain and disability were contributing factors to patterns of choice. Generally, patient preferences were situation specific. Recommendations have been made for improving professional sensitivity towards patients whose situation makes them more vulnerable to errors of judgement. Further avenues for research have been sketched.

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