Consent and shared decision-making
Dr Mark Dinwoodie, MPS Head of Member Education, looks at the term ‘shared decision-making’ and asks: what exactly does it mean and what are its benefits?
The increasing sophistication of healthcare, with an expanding number of available treatment options, set in the context of patients with rising levels of morbidity and expectations, has made decision-making more complex and challenging for both doctors and their patients. It’s perhaps not surprising that a model of decision-making that takes account of these issues, incorporates ethical and legal requirements, respects many patients’ increasing desire for involvement – while also incorporating the expertise of the clinician – has emerged.
Consent and decision-making
The requirements of the discussion process that contributes to the validity of consent have changed significantly over the last 30 years. Neither a paternalistic model of “doctor knows best” nor an informative approach of “here’s all the information, you decide” fulfil the requirements of a decision-making process outlined above. These two styles are different from making the decision in partnership with the patient, where there is an exchange of knowledge and opinion (see Box 1).