Ethically Based Decision Making – An Insightful Discussion

Ethical Models of Decision Making

The study of ethical models of decision-making in health care has led to important policy debates. This paper explores how hospitals in the United States use ethical models to provide services to patients in need of urgent care.

Qualitative Study Of Health Care

A person standing in front of a stove

To explore how patients report reliance on surrogate decision-making by hospitalized adults lacking independent decisional power, we conducted a qualitative study of a health care setting. Overall, 72% of participating doctors identified a specific ethical model related to surrogate decision-making as the most influential ethical model for surrogate decision-making (60% identified advanced directives, 6% substituted surrogate decision-making with judgment, and 4% defined individual judgment). Most of these doctors did not believe that their decision to participate in the study was motivated by an interest in patient welfare, nor did they report a desire to help improve patient welfare. Instead, they stated that they were participating in the study to improve patient welfare. It is interesting that many doctors were willing to place a more pragmatic agenda over the welfare of patients.

Process Of Medical Decision Making


The process of medical decision-making in a hospital setting can be complex, confusing, and difficult for many patients. When patients do not feel as if they are the ones making the decisions, their ability to understand and take responsibility for their own health deteriorates. Many patients report feeling helpless when faced with difficult decision-making situations. Furthermore, many physicians who participate in the study described their patients as being in their “powerlessness” and inability to make choices on their own.

As illustrated in previous literature, patients are able to express their feelings about their health care and the decisions related to it in various ways. Although patients can communicate to their family members and others about their decisions, patients do not always have the power or the resources to make informed decisions about their health. Even when patients do have these resources, they may not feel empowered to communicate their decisions in order to improve their health.

Managing Own Health With Necessary Tools

Doctors can provide patients with the tools necessary to manage their own health in their own time and space and to change their decisions and their feelings at their own pace in their own space and time. Patients in our study reported a wide range of experiences with their doctors regarding their decision-making processes, including their own sense of control, their ability to understand the information provided and the information presented to them, and the information they were able to take responsibility for themselves. and what they needed to change. Our research also revealed that many patients were interested in learning more about their decisions and their own health care; they expressed their desire to make informed decisions.


Some health care providers also told us that they felt pressured by hospitals and other healthcare administrators to give patients a more participative role in their health care decisions. Others said that they had a difficult time understanding how they could make informed decisions without fully understanding the information presented to them. The majority of health care providers said that they were not confident about whether patients had complete control over their health care decisions.

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