Patient participation

Shared decision making is a concept in medical care in which doctors explain treatments and alternatives to patients, and patients choose the course of action most consistent with their unique personal and cultural preferences. This concept may be contrasted with the paternalistic model of medical decision making, which was prevalent until the 1990s, in which doctors told patients what to do, and the patients unquestioningly obeyed. Cultural events such as the 1990 Cruzan v. Director, Missouri Department of Health Supreme Court case and the 1976 case of Karen Ann Quinlan have increased the importance of patient autonomy in medical ethics; shared decision making entails giving patients more influence in medical decisions.

Shared decision making combines evidence-based medicine with the preferences of patients.

Shared decision making emphasizes the importance of communication in the process of making a decision.

Rationale for shared decision-making

Many medical decisions are not strictly based on science. Patients have values that emphasize risks and benefits differently from their doctor. There is frequently more than one correct decision. Emerging importance of patient autonomy. Recognition of informed consent as an important component of decision making. Risk-benefit calculation renders not a single absolute recommendation but an assessment of outcome with more or less statistical certainty behind it.