作者: Gregory W. Ruhnke , Sandra R. Wilson , Takashi Akamatsu , Takaaki Kinoue , Yutaka Takashima
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摘要: Background: Patient-centered decision making, which in the United States is typically considered to be appropriate, may not universally endorsed, thereby harboring potential tocomplicate care of patients from other cultural backgrounds inpotentially unrecognized ways. This study compares attitudes towardethical making and autonomy issues among academic andcommunity physicians medical center outpatient clinicsin Japan States. Methods: Aquestionnaire requesting judgments about seven clinical vignettes wasdistributed (in English or Japanese) sample groups Japanesephysicians (n = 400) 65) as well US physicians(n 120) 60) that were selected randomly fromacademic institutions community settings (Tokyo andthe surrounding area) (the Stanford/Palo Alto, CA, area). Responses obtained 273 Japanese (68%),58 (89%), 98 (82%), 55 USpatients (92%). Physician patient compared onindividual items, composite scores derived subsets items relevant autonomy, family authority, physicianauthority. Results: A majority both physiciansand patients, but only a minority agreed should informed an incurable cancerdiagnosis before their terminally illpatient wishing die immediately ventilated, even ifboth doctor patient's want ventilated(Japanese vs p Conclusions: Family andphysician opinions are accorded larger role decisionmaking by sampled than those inthe States, although cultures place greater emphasis onpatient preferences on physician. Our results consistent with view context shapesthe relationship patient, physician, patient'sfamily making. The emphasize need forclinicians aware these affect andfamily responses different situations, potentiallyaffecting satisfaction compliance withtherapy.