The adherence to patient preference is a cornerstone of a quality evidence-based healthcare system. The shift to a more patient-centered approach in the medical practice has received accolades in the literature and has become a mainstay in the articles on evidence-based practice. Medical practitioners are instructed to include the patients in the decision-making process, as it is ultimately the patient’s health that is being decided. However, sometimes, the patient’s preference is at odds with the medical expertise of the care provider.
The inclusion of the patient in creating the evidence-based approach is solidified in literature as a positive practice. The scholars describe it as a shift in power from those that give care to those that receive it (Iowa Model Collaborative, 2017). However, there may exist instances when this power is not used for the patient’s benefit. A prime example of a situation where the patient’s preference and the scientific consensus are at odds is the phenomenon of Anti-Vax hysteria (Pandolfi, 2018).
The refusal to vaccinate has already resulted in several outbreaks of vaccine-preventable diseases and resulting casualties. The scenario that includes this particular type of preference is a common one: a mother, afraid of the perceived consequences, refuses to vaccinate her child. Vaccine hesitancy is a complex phenomenon that is very context-dependent, so there exists no single solution. However, a promising avenue of intervention is an involved and personal face-to-face dialogue. Petrelli, Contratti, Tanzi, and Grappasonni (2018) have found that vaccine-hesitant patients need someone to listen to their concerns, show understanding, and reassure them. Explaining the risks of vaccine-preventable diseases is more effective than trying to correct their misconceptions about the vaccine itself.
The evidence-based approach requires medical professionals to listen to their patients and include them in decision-making. However, sometimes, the patients’ preferences and medical expertise are in disagreement. These disagreements can pose a significant risk not only to the patient’s health but also to the health of others in the distant future. While there is no single solution, open dialogue, understanding, and an explanation of the risks should be the primary mode of mediation if such a conflict arises.
References
Iowa Model Collaborative (2017). Iowa Model of Evidence-Based Practice: Revisions and Validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182.
Pandolfi, F., et al. (2018). The Importance of Complying with Vaccination Protocols in Developed Countries: “Anti-Vax” Hysteria and the Spread of Severe Preventable Diseases. Current Medicinal Chemistry, 25(42), 6070-6081.
Petrelli, F., Contratti, C. M., Tanzi, E., Grappasonni, I. (2018). Vaccine hesitancy, a public health problem. Annali Di Igiene : Medicina Preventiva E Di Comunita, 30(2), 86-103.