Why do people want to be involved in shared decision-making?
There are various reasons why people may wish to share decision making with health professionals when agreeing on choices about their treatment, care and lifestyle....
People do not always want to be involved in making decisions about their care and treatment. They may make an active choice to leave an important decision to a trusted health professional. They may feel that they cannot make a contribution because they feel unqualified or know little about the options. Others may not feel able to be involved until they feel more informed, or more confident to do so, for example because they have gained experience of their illness. Even those who are very used to making choices about their health can sometimes shy away from decision making under different circumstances, such as experiencing a new condition or illness.
People may not want to share in decision making about their treatment because they trust their doctors to make the right choices for them. They may feel that health professionals know more about their condition than they do and so feel confident putting their care into their doctor’s hands. This may particularly affect people who have recently received a diagnosis of a potentially life-threatening condition, such as cancer or HIV. However, people may feel this way about choosing treatments in a wide range of situations.
Health decisions are not always urgent, even when the illness is serious. People sometimes felt the decisions they were being asked to make could be delayed until the point when it had to be faced. Another reason people gave for deferring decision making was feeling that they did not have enough information at that time or, that their doctors did not know enough to adequately inform them.
Sometimes people prefer to make decisions on their own with little input from their doctors, because they feel competent enough to do so. This may happen when people know a lot about their long-term condition (e.g. diabetes) or when they are making decisions for other people, (for examples parents deciding whether to vaccinate their children may choose to do their own research) Sharing decision making can be difficult when people are making choices for relatives (see also ‘Decisions involving values and difficult personal choices‘). People may experience guilt or worry about whether they were doing the right thing, especially if their choices could have serious consequences for people they love, for example relatives or unborn children.
People also said that they did not take part in making decisions about their health conditions because their doctors did not expect them to, or did not want them to. Others felt that doctors are not only best placed to make choices, but there are some decisions that should be the doctors’ responsibility.
In order for shared decision making to be successful, both patients and doctors need to take part. However, patients may not want to participate choosing instead to allow doctors to make the decisions. On the other hand, they may prefer to minimise their doctor’s input, in some cases even excluding him/her entirely. Those recently diagnosed with a life-threatening illness may feel too shocked to make choices, whereas those with long-term chronic conditions may become sufficiently informed and educated to take on the responsibility of decision making. Communication between doctors and patients is vital in ensuring successful shared decision making. This will be further discussed in ‘What can go wrong when decisions are not shared‘.
There are various reasons why people may wish to share decision making with health professionals when agreeing on choices about their treatment, care and lifestyle....
It is often said that relationships between patients and doctors have changed dramatically over the last 50 years. In the 1960s it would have been...