Shared understanding before decision making
Whilst messing about on social media this weekend I stumbled across some conversations that gave me a bit of a jolt. Shared decision making, that pillar of the consultation in healthcare, something I thought was an unassailable pursuit, was under attack. Some even commented that it should be ditched altogether. In favour of what I thought? A return to paternalism? Perish the thought! I was incensed! I couldn’t stop thinking about this and wondering why some of my medical colleagues around the world had turned against this approach and were now describing it in a number of disparaging ways. Views ranged from it being a rather pompous term where the rhetoric far outstrips the reality to being something which is an assault on patient autonomy or in some cases, an assault on physician autonomy. In some cases, surely, doctor knows best? Shared decision making has been described as ‘a process in which both the patient and the physician contribute to the decision-making process.’ Other