Re-engineering shared decision-making

Shared decision-making is widely accepted as the gold standard of clinical care. Numerous obstacles to achieving shared decision-making have been identified, including patient factors, physician factors and systemic factors. Until now, the paradigm is seldom successfully implemented in clinical prac...

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Bibliographic Details
Published inJournal of medical ethics Vol. 41; no. 9; pp. 785 - 788
Main Author Gillick, Muriel R
Format Journal Article
LanguageEnglish
Published England Institute of Medical Ethics and BMJ Publishing Group Ltd 01.09.2015
BMJ Publishing Group Ltd
BMJ Publishing Group LTD
Subjects
Decision making
Decision Making - ethics
Ethical aspects
Goals
Health aspects
Humans
Methods
Patient Participation - methods
Patient Participation - trends
Patient-Centered Care - ethics
Physician and patient
Physician-patient relations
Physician-Patient Relations - ethics
Physicians
Practice
Viewpoint
Decision-making
Paternalism
Autonomy
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Summary:Shared decision-making is widely accepted as the gold standard of clinical care. Numerous obstacles to achieving shared decision-making have been identified, including patient factors, physician factors and systemic factors. Until now, the paradigm is seldom successfully implemented in clinical practice, raising questions about the practicality of the process recommended for its use. A re-engineered model is proposed in which physicians elicit and prioritise patients’ goals of care and then help translate those goals into treatment options, after clarifying the patient's underlying health status. Preliminary evidence suggests that each step of this revised process is feasible and that patients and physicians are comfortable with this strategy. Adoption of this model, after further testing, would allow the goal of shared decision-making to be realised.
ISSN:0306-6800
1473-4257
DOI:10.1136/medethics-2014-102618