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Of medical facts and value judgments

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Normal breast at left,  cancerous one at right.

Peter A. Ubel, M.D., writing about his wife’s breast-cancer treatment, says: “Often medical facts — such as data on rates of cancer recurrence versus rates of fibrosis — don’t point toward an objectively superior treatment but instead reveal trade-offs, whereby the best choice for an individual patient depends on her preferences, on how she weighs the relative pros and cons of her alternatives.”

“This distinction between facts and value judgments has long been emphasized by experts on decision making, and not just in the medical domain. ”

“In some cases, I expect that the value judgments physicians and professional societies make are shared by their patients. But sometimes physicians’ values differ in important ways from those of many patients. When such value judgments are incorporated into professional treatment guidelines, without any explicit acknowledgment that a reasonable patient might choose an alternative course of treatment, they take potential choices away from patients.”


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