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Related Concept Videos

Ethical Dilemmas II01:30

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Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
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Ethical Issues01:27

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Saving Shared Decision-Making.

Douglas J Opel1, Maya T Gerstein2, Adam C Carle3,4

  • 1Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, Seattle, WA, USA. douglas.opel@seattlechildrens.org.

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|February 14, 2025
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Summary
This summary is machine-generated.

Shared decision-making (SDM) progress is slow due to confusion over equipoise. This paper argues equipoise is not essential for SDM and advocates for focusing on implementation science instead.

Keywords:
health communicationmedical ethicspatient preferenceshared decision-making

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Area of Science:

  • Healthcare Research
  • Patient-Centered Care
  • Clinical Decision-Making

Background:

  • The Agency for Healthcare Research and Quality called for re-evaluating shared decision-making (SDM) in 2016.
  • Progress in SDM has been hindered by a lack of consensus on its relationship with equipoise.
  • This ambiguity creates confusion regarding the appropriate application of SDM.

Discussion:

  • The current focus on equipoise as a criterion for SDM is counter-productive.
  • Equipoise is neither a necessary nor a sufficient condition for determining the need for SDM.
  • Rethinking the role of equipoise can clarify SDM indications.

Key Insights:

  • Equipoise is not a prerequisite for implementing shared decision-making.
  • Confusion surrounding equipoise impedes the advancement of SDM.
  • A paradigm shift is needed to overcome current limitations.

Outlook:

  • Future research should prioritize advancing the science of SDM implementation.
  • Focusing on 'how' to achieve SDM across diverse contexts is crucial.
  • This shift will accelerate progress in patient-centered care and clinical practice.