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Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)
Abstract
Shared decision-making is increasingly advocated as an ideal model of treatment decision-making in the medical encounter. To date, the concept has been rather poorly and loosely defined. This paper attempts to provide greater conceptual clarity about shared treatment decision-making, identify some key characteristics of this model, and discuss measurement issues. The particular decision-making context that we focus on is potentially life threatening illnesses, where there are important decisions to be made at key points in the disease process, and several treatment options exist with different possible outcomes and substantial uncertainty. We suggest as key characteristics of shared decision-making (1) that at least two participants-physician and patient be involved; (2) that both parties share information; (3) that both parties take steps to build a consensus about the preferred treatment; and (4) that an agreement is reached on the treatment to implement. Some challenges to measuring shared decision-making are discussed as well as potential benefits of a shared decision-making model for both physicians and patients.
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“The shared decision making model suggests that HCPs can facilitate shared decisions by presenting treatment options, outlining the benefits and risks, and helping patients/caregivers to evaluate these options against their own goals and preferences.[36–37]”
From Perceived healthcare provider reactions to patient and caregiver use of online health communities (2014) · cites this paper as [37]
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Metadata
- Authors
- Charles, C., Gafni, A., & Whelan, T.
- Affiliations
- McMaster University (CA)
- Corresponding author
- Charles, Cathy
- ORCID
- Gafni, Amiram
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 1997-03
- Volume
- 44
- Issue
- 5
- Pages
- 681-692
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W2040607890
- Cited by
- 4,137
- References
- 68
- Citations by year
- 2026: 168 · 2025: 200 · 2024: 224 · 2023: 213 · 2022: 174 · 2021: 247 · 2020: 250 · 2019: 233 · 2018: 224 · 2017: 234 · 2016: 209 · 2015: 182 · 2014: 221 · 2013: 192 · 2012: 187
- FWCI
- 63.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- shared decision-making, physician-patient relationship, treatment decision-making, shared information, consensus building, patient involvement in care
- MeSH terms
- Decision Making, Humans, Informed Consent, Models, Psychological, Patient Participation, Physician-Patient Relations, Patient Satisfaction
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