Survey experiment reveals strong preferences for autonomous medical decisions over family-led choices in adults, highlighting the need for tailored patient-centered care strategies.
Key Points
To investigate how illness severity, clinical context, and sociodemographic characteristics determine patient preferences for family involvement in medical decision making.
Conducted a vignette-based survey experiment in 2024 among a sample in Belgium (N = 1,175) evaluating skin cancer and randomly assigned mild or severe depression scenarios.
Used ordered logistic regression models to evaluate associations between decision-making preferences and sociodemographic, economic, and religious factors.
Patient-led decision making was preferred by the vast majority across scenarios (77.4% for skin cancer, 70.9% for severe depression, and 81.0% for mild depression), while family-led decisions were rare (1.2%, 2.7%, and 1.4%, respectively).
Shared decision making with family members was most frequently favored in severe depression (26.4%), compared to skin cancer (21.4%) and mild depression (17.6%).
Living with a partner, having a migration background, and identifying as Christian were associated with higher preference for family involvement, whereas higher educational attainment was associated with lower preference.