Paternalism, probability and prostate specific antigen.

摘要

A recent episode of the radio program "This American Life" narrates the unfortunate plight of a doctor who while a family practice resident counseled a 53-year-old patient whether to have a prostate specific antigen (PSA) assay performed. He explained to his patient the benefits and risks of PSA testing, and the man chose not to have the test. A year and a half passed, and the patient saw another physician who performed PSA screening routinely and without discussion. The worst possible prospect then transpired. The PSA was elevated and a biopsy revealed aggressive carcinoma. Inevitably, the man sued and the family practice residency program was found liable with a million dollar penalty. The radio journalist explained, "At the trial, the patient's attorney argued that (the doctor) shouldn't have given the man a choice to have the PSA test, no matter what the national guidelines said."