A patient in the clinic; a person in the world. Why shared decision making needs to center on the person rather than the medical encounter. Issue 3 (March 2017)

• Record Type: Journal Article
• Authors: Clayman, Marla L.; Gulbrandsen, Pål; Morris, Megan A.
• Is Part Of: Patient education and counseling. Volume 100:Issue 3(2017)
• Page Start: 600
• Page End: 604
• Publication Date: 2017-03
• Subjects: Shared decision making -- Patient-centered care -- Family engagement -- Decision partner; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2016.10.016
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract: Interest in shared decision making (SDM) has increased and become widely promoted. However, from both practical and measurement perspectives, SDM's origin as an outgrowth of patient autonomy has resulted in narrowly conceptualizing and operationalizing decision making. The narrow focus on individual patient autonomy fails in four main ways: 1) excluding several facets of the roles, actions, and influences of decision partners in decision making; 2) focusing solely on the medical encounter; 3) ignoring the informational environment to which patients have access; and 4) treating each encounter as independent of all others. In addition to creating a research agenda that could answer important outstanding questions about how decisions are made and the consequences thereof, reconceiving SDM as centered on the person rather than the medical encounter has the potential to transform how illness is experienced by patients and families and how clinicians find meaning in their work.