Journal article
Medical Students' Attitudes and Experiences Regarding Persuasion of Patients by Physicians: Clarifying the Ethics of Shared Decision Making
Journal of general internal medicine : JGIM, Vol.40(16), pp.3870-3878
12/2025
DOI: 10.1007/s11606-025-09807-w
PMCID: PMC12686280
PMID: 40906011
Appears in UI Libraries Support Open Access
Abstract
Ethical principles of autonomy and beneficence guide clinical decision making. Little is known about how clinicians prioritize these principles and integrate them with virtue ethics when assessing the ethics of persuasion.
Survey medical students about their attitudes and experiences regarding the use of persuasion by physicians in shared decision making.
Cross-sectional, on-line survey.
Pre-clinical and clinical medical students at one US medical school.
Survey instrument contained 31 items including a three-part clinical vignette, attitudes toward persuasion and ethical principles, experiences observing or participating in persuasion, and demographic information. Bivariate and multivariable analyses were performed, including LASSO regression using a 30-point persuasion score derived from six items.
237 students completed the survey (45% response rate). In general, 55.7% supported persuasion by physicians for the good of the patient's health. Nearly half supported persuasion for an at-risk cardiovascular patient who declines recommendations for walking or statin treatment; 64.1% supported persuasion for a patient with myocardial infarction who wants to leave the hospital against medical advice. While 70.0% believed persuasion is appropriate because it promotes beneficence and nonmaleficence, 16.9% believed persuasion is inappropriate because it disrespects patient autonomy. Most students (81.0%) had seen a good physician role model for persuasion, and 38.0% had willingly participated in persuasion. LASSO regression identified four items contributing positively to the persuasion score (belief that persuasion promotes beneficence/nonmaleficence, observation of a good role model, experience participating in persuasion, male gender) and two negatively (belief that persuasion disrespects patient autonomy, observation of inappropriate use of persuasion).
Medical students vary in attitudes toward persuasion of patients by physicians, and variations are associated with differences in ethical beliefs, clinical experiences, and gender. Education regarding the use of persuasion should address ethical justification, experience, and role-modeling-which can be encompassed by virtue ethics.
Details
- Title: Subtitle
- Medical Students' Attitudes and Experiences Regarding Persuasion of Patients by Physicians: Clarifying the Ethics of Shared Decision Making
- Creators
- John Muckler - University of IowaJames C Thomas - University of IowaLaura Shinkunas - University of IowaLauris C Kaldjian - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.40(16), pp.3870-3878
- DOI
- 10.1007/s11606-025-09807-w
- PMID
- 40906011
- PMCID
- PMC12686280
- NLM abbreviation
- J Gen Intern Med
- ISSN
- 1525-1497
- eISSN
- 1525-1497
- Publisher
- Springer Nature
- Grant note
- Ethics Summer Research Fellowship through the Program in Bioethics and Humanities, Carver College of Medicine, University of Iowa
This work was supported by an Ethics Summer Research Fellowship through the Program in Bioethics and Humanities, Carver College of Medicine, University of Iowa.
- Language
- English
- Electronic publication date
- 09/04/2025
- Date published
- 12/2025
- Academic Unit
- Medical Ethics; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984958606202771
Metrics
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