There is a general agreement that guidelines should assist decision making by patients. However, there is less agreement on how this can be achieved. In this article, the recently published guidelines on referral for suspected cancer are used to illustrate some of the approaches adopted by the National Institute for Health and Clinical Excellence (NICE) in England Wales. It is argued that considerable progress has been made in recent years on ways of promoting patient involvement through guidelines,although some problems remain to be resolved before genuine involvement is achieved.
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