Ethical aspects of risk communication

The essence of risk communication is to provide patients with a clear understanding of the benefits, harms, trade-offs and uncertainties of any proposed treatment. Doctors often assume that they do this well but can overestimate the comprehension of even well-educated patients. We all make complex decisions using intuitive and deliberative thinking and there are hidden sources of bias in decision-making that apply to both doctor and patient. Recent research suggests that patients are best equipped to understand risk when they are simply able to ‘get the gist’ of the risks involved in their treatment as accurately as possible. This can be achieved by a process of thinking out loud in which the doctor outlines the nature of the problem and the factors they think might be important to the individual patient, while checking carefully for shared understanding along the way. We have an ethical obligation to keep on developing skills in how to convey knowledge with honesty, empathy and respect.