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Updated: May 29, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Shared mind: communication, decision making, and autonomy in serious illness.

Ronald M Epstein¹, Richard L Street

¹Departments of Family Medicine, Psychiatry, and Oncology, School of Medicine & Dentistry, and the and School of Nursing, University of Rochester Medical Center, Rochester, New York, USA. ronald_epstein@urmc.rochester.edu

Annals of Family Medicine

|September 14, 2011

Summary

Shared mind, a concept of collaborative cognition, enhances decision-making in serious illness by integrating perspectives from patients and clinicians. Promoting shared mind through communication fosters relational autonomy and better outcomes.

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Last Updated: May 29, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

Medical Communication
Health Psychology
Decision Science

Background:

Individuals often rely on others for support during serious illness decision-making.
Existing models of patient-clinician interaction range from transactional to interactional.

Purpose of the Study:

Introduce and define the concept of "shared mind" for understanding collaborative decision-making.
Explore how shared mind applies to patient-clinician interactions and decision-making in serious illness.
Propose that shared mind can enhance patient autonomy and decision-making processes.

Main Methods:

Conceptual analysis drawing on collaborative cognition, attunement, and sensemaking.
Exploration of a continuum of patient-centered approaches (interactional vs. transactional).
Proposal of shared mind as a framework for understanding and improving shared decision-making.

Main Results:

Shared mind emerges from the bidirectional sharing of thoughts, feelings, perceptions, meanings, and intentions.
An interactional approach to patient-clinician communication promotes relational autonomy.
Shared mind considers individual and emergent perspectives from all involved parties.

Conclusions:

Shared mind offers a valuable framework for enhancing shared decision-making in serious illness.
Clinicians can promote shared mind through bidirectional information sharing and deliberation.
Integrating shared mind perspectives can improve patient autonomy and decision-making outcomes.