In Reply: We agree with Dr Gates that trust
in the patient-physician relationship influences the style of decision making.
However, physicians may assume that patients desire a paternalistic posture,
despite evidence to the contrary.1,2
Patients want physicians they trust to make sound recommendations; they do
not want physicians to exclude them from any potential role in decision making.
Furthermore, even if patients rationally delegated their decisional authority
to their physicians,3 physicians should
still say enough to make their reasoning clear to the patient and work to
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