Desire for autonomy in health care decisions: a general population survey.

Abstract

OBJECTIVE: To examine factors associated with desire for autonomy in health care decisions in the general population. METHODS: Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). RESULTS: On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. CONCLUSIONS: The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. PRACTICE IMPLICATIONS: An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy.