I guess everyone has a cousin Ernest. He is the fellow of whom your mother asks . . . "Why can't you be more like your cousin Ernest?" Cousin Ernest went to the high school for genius children and got all A's, even in French. As the years went by, I lost contact with Cousin Ernest. Then last year, at a family gathering, I met him again. Sure enough, he had gone to Harvard and become a doctor, a radiologist. We began discussing his practice and he mentioned that he performs some fairly risky diagnostic tests. While legally he was compelled to tell patients about the risks they were undertaking, he said that risk disclosure was a useless exercise. "No one has ever refused to undergo the procedure," he said. It was difficult to argue with his observation that no patient ever refused to undergo his tests. I understood that the lack of refusals did not necessarily mean that risk disclosure was a useless exercise, but his underlying argument was quite compelling.

1. Introduction.- 2. Learning About Therapy.- Why Communicate Risks? - The Health Professional Perspective.- Why Communicate Risks? - The Patient Perspective.- Motivation to Seek Risk Information.- The Content of Risk Communication.- Sources of Risk Information.- Stimulating Risk Disclosure.- Implications.- 3. Physician's Risk Disclosure.- Normative Studies of Doctor-Patient Communication.- Information Exchange Standards.- Risk Disclosure Factors.- Moderating Factors - The Physician.- Moderating Factors - The Prescribing Environment.- Implications.- 4. Patient Information Processing.- Attention to Risk Information.- Comprehension.- Integration in Memory.- Processing Risk Communications.- Information Retrieval.- Implications.- 5. Patients' Medical Judgments.- The Patient as a Decision Maker.- Biases in Decision Making.- Patient Consent and Risk Acceptance.- Risk Communication and Compliance.- Implications.- 6. Effects of Risk Communication.- The Initial Doctor Visit.- Product Use.- Treatment Evaluation.- Maintaining Treatment.- Implications.- 7. Mass Media Risk Communication.- Historical Development of PPIs.- Assessment of PPI Effects.- Direct Advertising of Prescription Drugs.- Risk Disclosure in Television and Magazines.- Implications.- References.