Person-centred shared decision making.

Area of Science:

• Clinical Practice
• Healthcare Ethics
• Patient-Centered Care

Background:

• Current models of shared decision making (SDM) primarily focus on treatment choices.
• Clinicians provide options, while patients contribute values and preferences in traditional SDM.
• These elements are argued to make SDM suboptimal in real-world clinical practice.

Purpose of the Study:

• To propose a more effective model of shared decision making (SDM).
• To advocate for SDM as a comprehensive collaboration in all aspects of clinical care.
• To emphasize the importance of the clinician-patient relationship and understanding the patient as a person.

Main Methods:

• Conceptual argument and re-framing of SDM.
• Emphasis on the clinician-patient partnership and mutual respect.
• Illustrative examples of an alternative SDM model are provided.

Main Results:

• The proposed SDM model views collaboration across all clinical care aspects.
• Clinicians must engage with the patient's illness experience and treatment participation.
• An autonomy-supportive context requires clinicians to know patients personally.

Conclusions:

• Respecting patients as persons, beyond just their choices, is crucial for effective SDM.
• Clinicians understanding patients as individuals enhances autonomy support.
• This pragmatic SDM approach requires specific patient knowledge but not excessive time.