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Communications to the Editor |

Ethics in Decision Making and Patient Autonomy FREE TO VIEW

Abdullah Al-Mobeireek, MD, FCCP
Author and Funding Information

King Saud University Riyadh, Saudi Arabia

Correspondence to: Abdullah Al-Mobeireek, MD, FCCP, Department of Medicine (38), College of Medicine, King Saud University, PO Box 2925, Riyadh 11462, Saudi Arabia; e-mail: mobeireek@yahoo.com



Chest. 2001;120(2):688. doi:10.1378/chest.120.2.688
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To the Editor:

The study by Ruhnke et al (October 2000)1showed interesting differences between attitudes of American and Japanese subjects to information disclosure and decision making. The situation in Saudi Arabia is similar to that in Japan, and the family-centered model is preferred. In a previous study,2 75% of physicians in Saudi Arabia indicated that they gave information about serious illnesses such as cancer to the family first and then the patient if they approved. Physicians returning home after training in North America experience not infrequently the ethical dilemma highlighted by Ruhnke et al.

We feel that the increasing use of aggressive therapies nowadays and greater awareness in the information era mandate greater patient autonomy. This was also desired by patients in Saudi Arabia.3 On the other hand, patients in the study of Ruhnke et al wished for greater family and physicians’ involvement. Thus, it seems that in the United States the concept of patient autonomy has been overemphasized, while in Japan and Saudi Arabia it deserves more emphasis. Obviously, the individual situation may vary considerably, and we concur with the conclusions by Ruhnke et al that physicians need to exercise some flexibility when performing their role.

References

Ruhnke, GW, Wilson, SR, Akamatsu, T, et al (2000) Ethical decision making and patient autonomy: a comparison of physicians and patients in Japan and the United States.Chest118,1172-1182. [PubMed] [CrossRef]
 
Mobeireek, A, Al-Kassimi, F, Al-Majed, S, et al Communication with the seriously ill: physicians’ attitudes in Saudi Arabia.J Med Ethics1996;22,282-285. [PubMed]
 
Al-Ahwal, M Cancer patients’ awareness of their disease and prognosis.Ann Saudi Med1998;18,187-189. [PubMed]
 

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References

Ruhnke, GW, Wilson, SR, Akamatsu, T, et al (2000) Ethical decision making and patient autonomy: a comparison of physicians and patients in Japan and the United States.Chest118,1172-1182. [PubMed] [CrossRef]
 
Mobeireek, A, Al-Kassimi, F, Al-Majed, S, et al Communication with the seriously ill: physicians’ attitudes in Saudi Arabia.J Med Ethics1996;22,282-285. [PubMed]
 
Al-Ahwal, M Cancer patients’ awareness of their disease and prognosis.Ann Saudi Med1998;18,187-189. [PubMed]
 
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