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Shared decision-making and patient autonomy
Abstract
In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.
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“These perspectives support and are supported by prior research calling for MAiD care coordination, inter-professional approaches, and attention to applicants’ and families’ emotional, social and spiritual needs, among others [24, 25, 50–52].”
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Metadata
- Authors
- Sandman, L., & Munthe, C.
- Affiliations
- University of Gothenburg (SE)
- Venue
- Theoretical Medicine and Bioethics
- Published
- 2009-08
- Volume
- 30
- Issue
- 4
- Pages
- 289-310
- ISSN
- 0166-2031 (ISSN-L)
- 1386-7415
- 1573-1200
- OpenAlex
- W2080106940
- Cited by
- 138
- References
- 32
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 13 · 2022: 11 · 2021: 9 · 2020: 12 · 2019: 14 · 2018: 8 · 2017: 5 · 2016: 9 · 2015: 7 · 2014: 8 · 2013: 7 · 2012: 4
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Metamedicine (publishedVersion)
- PubMed (publishedVersion)
- Borås Academic Digital Archive (University of Borås) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Keywords
- shared decision-making, patient autonomy, patient-centered care, self-realization, preference satisfaction, self-direction, clinical decision-making
- MeSH terms
- Choice Behavior, Decision Making, Humans, Patient Acceptance of Health Care, Patient Education as Topic, Patient Participation, Physician-Patient Relations, Truth Disclosure, Negotiating, Professional Autonomy, Patient Satisfaction, Personal Autonomy, Paternalism
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