In Reply We appreciate the comments from Weeks and Weinstein regarding our article.¹ We agree with Weeks and Weinstein that information about mortality and out-of-pocket costs matter to patients who are considering surgical intervention. Like other types of information, eg, risks or alternative treatments, we worry that simple disclosure of data is not enough to make a shared decision. Policies designed ostensibly to promote shared decision making that instead target types of information for disclosure encourage a buyer-beware attitude for patients, with little regard for the clinical skill required to present choices, elicit preferences, and ensure the treatment plan is aligned with the patient’s goals and values. After all, decisions around out-of-pocket costs and location of surgery have tradeoffs. Some patients may prefer a small increase in mortality to have care closer to home, while others might prefer to receive care from a specific surgeon or institution despite large out-of-pocket costs. To support shared decision making, the surgeon’s job is not to simply disclose information but instead to assist patients as they navigate this unfamiliar territory.

在答复中，我们感谢Weeks和Weinstein对本文的评论。^1个我们同意Weeks和Weinstein的观点，即有关死亡率和自付费用的信息对正在考虑进行手术干预的患者至关重要。像其他类型的信息，例如风险或替代处理一样，我们担心简单的数据披露不足以做出共同的决定。表面上旨在促进共享决策的政策，其反而针对的是要公开的信息类型，因此鼓励患者对患者保持购买者当心的态度，而很少考虑提出选择，引起偏好并确保治疗计划与患者的治疗方案相符的临床技能。目标和价值观。毕竟，围绕自付费用和手术位置的决策需要权衡取舍。有些患者可能希望死亡率略有增加，以便在家附近就医，而其他人则可能愿意从特定的外科医生或机构那里获得护理，尽管需要支付大量的自付费用。为了支持共同的决策制定，外科医生的工作不是简单地披露信息，而是在患者浏览这个陌生领域时为患者提供帮助。