Critical Decisions: Reviews

The Hastings Center: Bringing Doctor-Patient Medical Decision Making Into Focus – Meredith Stark (July-August 2014)

When I finally got eyeglasses as a teenager, after denying the need for far too long, I was repeatedly surprised by the world that everyone else had been seeing all along. Leaves on the trees, graffiti by the highway—I was astonished, amazed, and suddenly informed. It is easy to assume we are seeing all we need to see, knowing all we need to know, until something jars us from this false comfort and compels us to reconsider. So it is with thinking about the current state of doctor-patient decisions. The unfocused view has physicians listening to patients and clearly communicating information about illnesses and treatment options, patients making good use of high-quality data to craft sound decisions, and doctors joining patient preference with provider beneficence to optimize decisions. The reassuring outlook finds physician paternalism defeated, patients empowered, and all right with the world.

Peter Ubel cannot let that fiction stand. In Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together, Ubel reminds us that our work in actualizing patient autonomy and fostering patient participation in critical health decisions remains far from over.

As suggested by its subtitle, Critical Decisions is a book written for patients, though its value for physicians, bioethicists, educators, and students should not be underestimated. Deftly drawing upon his expertise as a physician, ethicist, and behavioral scientist, Ubel aims to improve the quality of health care decisions by arming his readers with vital intelligence…. (Read the rest here.)


Emmi Solutions: A Review of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together – Geri-Lynn Baumblatt (May 14, 2014)

This is a very belated review. And I mean that as a compliment. As soon as I finished reading Peter Ubel’s Critical Decisions, I immediately leant it out to a colleague as a very enjoyable “must-read.” She devoured it and passed it along to yet another colleague – and that was literally the last I saw of my copy, which I hope to eventually get back in some kind of battered but well-read condition. Yes, we’ve ordered more copies. But I think everyone keeps passing it on because Critical Decisions provides a wealth of history and information about medical decision making, and how doctors and patients each think about decisions. Perhaps most importantly, it shows the author confronting the reality of how medical decision making actually plays out in the real world…(Read the rest here)

Theoretical Medicine and Bioethics: Ubel, Peter: Critical Decisions: how you and your doctor can make the right medical choices together – Thomas Cunningham (April 27, 2013)

Though written for a popular audience, Peter Ubel’s Critical Decisions: How You and Your Doctor Can Make the Right Choices Together will be important reading for medical practitioners and theorists alike. In it, Ubel presents a new approach for making medical decisions directly to health care consumers, drawing on his research on the psychology of medical decision-making and training in medicine and bioethics. This approach focuses on communication between doctors and patients rather than on patients’ rights or physicians’ duties. Given the targe taudience, the book is rarely explicit about its arguments. But implicit in Ubel’s narrative is the claim that, like it or not, there is a new order in medicine, where patients and physicians must literally work together to make medical decisions; and,moreover, that there are empirically measurable ways to assess our failures and increase our successes at doing so. His narrative is engaging and fresh. For its purposes, the book is excellent…(Read the rest here)

The American Journal of Bioethics: Review of Peter Ubel, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together – Zackary Berger (March 20, 2013)

The ethical issues inherent in medical decisions have always been fraught and are no less so today. “Yes,” you might think, “that’s obvious, because the patient is not able to participate in medical decisions that affect his or her life.” But in his powerful and groundbreaking Critical Decisions, Peter Ubel persuasively argues that one of our age’s most momentous barriers to patient-centered health care comes from just the opposite direction: Patients are now supposed to be all the more involved in their medical decision making, in the name of patient autonomy; however, this responsibility is something neither they nor their doctors are ready for…(Read the rest here)


Health Affairs: Medical Decisions: Shared, Or Impaired? – Chris Trimble (February 2013)

Who decides? Doctor or patient? For decades, too many of the advocates who have tangled with the establishment to empower patients have acted as though there is only black and white. The patient decides, not the doctor. The result has been a toxic standoff…By throwing the dichotomy under the bus, Ubel takes a crucial step forward. Patients and doctors must work together to get to the right decision.The much tougher questions follow:How?What are the rules of engagement? How should the interaction proceed? Who does what?… Ubel’s expert dissection of the hidden complexities of these questions is thorough and impressive. In addition, Ubel is quite evidently a gifted writer,thinker, and communicator. Critical Decisions is a first-rate effort to popularize the science of medical decision making. Some readers will devour this book;in fact, researchers in the medical decision-making community might finish it in a single sitting. And general readers with an intellectual interest in healthcare—those who eagerly anticipate Atul Gawande’s next New Yorker article, for example—will find much to like here…(Read the rest here)


The Saturday Age, Melbourne – Fiona Capp (October 20, 2012)

IN THE 1970s, there was a revolution in doctor- patient relations. Physician paternalism was out. Patient power was in. Doctors started giving patients the facts they needed to make informed decisions about their treatment. But for all the patients’ newly acquired rights, patients and doctors still struggled to get the balance right. There was still much to be understood about how emotion and cognitive illusions influenced decision- making. Physician Peter Ubel not only tells the story of this revolution and what has been learnt from it, but also captures the patients’ perspectives through case studies and his wife’s journey as a cancer patient. Ubel shows how decision aids (such as videos) and decision coaches are being used to help patients be more actively involved, and how doctors can themselves be better prepared. Packed with human drama, this is a well-told “how to” with universal relevance…(Read the original here)


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