ABSTRACT
A physician’s fiduciary obligation is to act in the best interests of his or her patient, which should not be overridden by requests of the patient’s family members. While family members sometimes can – and do – make health care decisions on behalf of patients, this is only justified when family members serve as substitute decision makers in situations where the patient lacks capacity or when the family member is explicitly given durable power of attorney. As such, pathophysiology is critical for the external validity of evidence-based medicine. Moreover, because randomly selected populations are never homogenous, understanding pathophysiological mechanisms can allow physicians to determine whether subject groups are in fact comparable to their individual patients. While evidence-based medicine has become the principle methodology of physicians for offering medical care, complementary and alternative medicine is still nevertheless popular among many different patient populations.
