My patient and I were locked in a game of decision-making hot potato.

“What would you do, Doc?” he said. We’d been discussing whether he should get screened for prostate cancer.

Such questions trouble most doctors. We often lob the choice back to patients, or “on the one hand, on the other hand” so much that they start sympathizing with Harry Truman, who reportedly joked he wished for one-handed advisers.

But the evidence wasn’t clear. I passed the potato back.

Medicine’s decades-long march toward patient autonomy means patients are often now asked to make the hard decisions — to weigh trade-offs, to grapple with how their values suggest one path over another. This is particularly true when medical science doesn’t offer a clear answer: Doctors encourage patients to decide where evidence is weak, while making strong recommendations when evidence is robust. But should we be doing the opposite?

Research suggests that physicians’ recommendations powerfully influence how patients weigh their choices, and that while almost all patients want to know their options, most want their doctor to make the final decision. The greater the uncertainty, the more support they want — but the less likely they are to receive it.