Full Description
Patients today are more empowered and knowledgeable than they have ever been. By law, they must be told about the risks and benefits of proposed treatments and give informed consent before treatment is initiated. Through the democratization of medical information, they have access to peer-reviewed medical journals. Social media allows patients to share stories with others and to learn about other people's experiences with various treatments. There are websites written by experts at leading medical schools to help patients understand diseases and treatments. They have the right to see their medical records. The net result of all changes is a shift in the power balance between doctors and patients. Ideally, as a result of these shifts, the patients' values and preferences should guide treatment decisions.
However, this proliferation of information often leads to confusion rather than clarity. Publicly available information often includes seemingly contradictory conclusions and recommendations. Patients don't know which opinions to trust. So, although patients have more information than ever, and many want to make decisions for themselves, they need more guidance than ever to help them process an avalanche of information.
This volume aims to help both medical professionals and their patients navigate the evolving healthcare landscape by analyzing the process of shared decision-making (SDM) in clinical medicine. The concept of SDM has emerged in the last two decades as a middle ground between, on the one hand, old-fashinioned physician paternalism of the "doctor-knows-best" variety and, on the other hand, unfettered patient autonomy by which patients are thought capable of individually and independently choosing their own medical interventions. Advocates of SDM imagine that decisions will be made best if they follow a complex discussion and negotiation between doctor and patient; such discussions should incorporate the doctor's medical and technical expertise as well as the patient's goals, values, and preferences. SDM takes different forms for different patients in different clinical circumstances.
This volume gathers experts in SDM to share their insights about how it ought to be done. The authors include clinicians, social scientist, and philosophers, all of whom have thought about or cared for patients from a variety of backgrounds and in a variety of clinical circumstances. The papers explore the complexity of SDM and offer practical guidance, gained from years of experience, about how to employ SDM as effectively as possible.
Contents
Introduction: The Fascinating Synergy of Shared Decision Making
John D. Lantos
Chapter 1: Surrogate's Personal Sense of Duty as a Crucial Element in Medical Decision-Making: Ethical, Empirical, and Experience-Based Perspectives
Chris Feudtner, Theodore Schall, and Douglas Hill
Chapter 2: Clinical Medical Ethics and the Historical Background of Shared Decision-Making
Mark Siegler
Chapter 3: Practical Wisdom, Rules, and the Patient-Doctor Conversation
Daniel Brudney
Chapter 4: Scaffolding Autonomy: Respecting Persons in Shared Decision Making.
Jodi Halpern and Aleksa Owen
Chapter 5: Serious Pediatric Illness: A Spectrum of Clinician Directiveness in Collaborative Decision Making
Jonna D. Clark, Mithya Lewis-Newby, Alexander A. Kon, and Wynne Morrison
Chapter 6: A Pragamatic Guide to Shared Decisionmaking in Pediatrics: A Justification and Concrete Steps
Jennifer Walter and Alexander Fiks
Chapter 7: The Role of Children and Adolescents in Decision Making about Life-Threatening Illness
Victoria A. Miller and Melissa K. Cousino
Chapter 8: A Stepwise Framework for Shared-Decision Making
Kimberly E. Sawyer and Douglas J. Opel
Chapter 9: Cross-Cultural Interactions and Shared Decision-Making
Sabrina F. Derrington and Erin Paquette
Chapter 10: Biases and Heuristics that Subtly Shape Decisions
Jennifer Blumenthal-Barby
Chapter 11: Shared Decision-Making, Truth-Telling, and the Recalcitrant Family
John D. Lantos
