Results for 'Shared decision-making'

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  1. Shared decision-making and patient autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of (...)
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  2. Shared Decision Making, Paternalism and Patient Choice.Lars Sandman & Christian Munthe - 2010 - Health Care Analysis 18 (1):60-84.
    In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the (...)
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  3.  9
    Shared Decision-Making for Implantable Cardioverter-Defibrillators: Policy Goals, Metrics, and Challenges.Birju R. Rao, Faisal M. Merchant, David H. Howard, Daniel Matlock & Neal W. Dickert - 2021 - Journal of Law, Medicine and Ethics 49 (4):622-629.
    Shared decision-making has become a new focus of health policy. Though its core elements are largely agreed upon, there is little consensus regarding which outcomes to prioritize for policy-mandated shared decision-making.
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  4. Does Shared Decision Making Respect a Patient's Relational Autonomy?Jonathan Lewis - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1063-1069.
    According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational (...)
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  5. Adherence, shared decision-making and patient autonomy.Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe - 2012 - Medicine, Health Care and Philosophy 15 (2):115-127.
    In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as (...)
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  6. Shared decision-making in maternity care: Acknowledging and overcoming epistemic defeaters.Keith Begley, Deirdre Daly, Sunita Panda & Cecily Begley - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1113–1120.
    Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to (...)
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  7. Shared decision-making, gender and new technologies.Kristin Zeiler - 2007 - Medicine, Health Care and Philosophy 10 (3):279-287.
    Much discussion of decision-making processes in medicine has been patient-centred. It has been assumed that there is, most often, one patient. Less attention has been given to shared decision-making processes where two or more patients are involved. This article aims to contribute to this special area. What conditions need to be met if decision-making can be said to be shared? What is a shared decision-making process and what is a (...)
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  8.  8
    Beyond Shared Decision Making.Edmund G. Howe - 2020 - Journal of Clinical Ethics 31 (4):293-302.
    Shared decision making (SDM) is the state of the art for clinicians’ communication with patients and surrogate decision makers. SDM involves give and take, in which all parties interact to maximize the autonomy of patients. In this article I summarize the core steps of SDM and explore ways to use it to benefit patients to the greatest extent. I review three articles included in this issue of The Journal of Clinical Ethics that highlight additional approaches we (...)
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  9.  26
    Why shared decision making is not good enough: lessons from patients.Gert Olthuis, Carlo Leget & Mieke Grypdonck - 2014 - Journal of Medical Ethics 40 (7):493-495.
    A closer look at the lived illness experiences of medical professionals themselves shows that shared decision making is in need of a logic of care. This paper underlines that medical decision making inevitably takes place in a messy and uncertain context in which sharing responsibilities may impose a considerable burden on patients. A better understanding of patients’ lived experiences enables healthcare professionals to attune to what individual patients deem important in their lives. This will contribute (...)
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  10.  96
    Shared decision-making and maternity care in the deep learning age: Acknowledging and overcoming inherited defeaters.Keith Begley, Cecily Begley & Valerie Smith - 2021 - Journal of Evaluation in Clinical Practice 27 (3):497–503.
    In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...)
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  11.  18
    Shared Decision Making in Psychiatry: Dissolving the Responsibility Problem.Leila El-Alti - 2023 - Health Care Analysis 31 (2):65-80.
    Person centered care (PCC) invites ideas of shared responsibility as a direct result of its shared decision making (SDM) process. The intersection of PCC and psychiatric contexts brings about what I refer to as _the responsibility problem_, which seemingly arises when SDM is applied in psychiatric settings due to (1) patients’ potentially diminished capacities for responsibility, (2) tension prompted by professional reasons for and against sharing responsibility with patients, as well as (3) the responsibility/blame dilemma. This (...)
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  12.  43
    Shared Decision Making After MacIntyre.J. Tilburt - 2011 - Journal of Medicine and Philosophy 36 (2):148-169.
    This paper explores the practical consequences that Enlightenment ideals had on morality as it applies to clinical practice, using Alisdair MacIntyre's conceptualization and critique of the Enlightenment as its reference point. Taking the perspective of a practicing clinician, I critically examine the historical origins of ideas that made shared decision making (SDM) a necessary and ideal model of clinician-patient relationship. I then build on MacIntyre's critique of Enlightenment thought and examine its implications for conceptions of shared (...)
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  13.  10
    Shared Decision Making Still a Goal and Not a Practice: How One Physician Learned about the Other Side, The Patient's Perspective.David S. Dinhofer - 2016 - Ethics in Biology, Engineering and Medicine 7 (1-2):11-19.
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  14.  10
    Shared Decision-Making in the Determination of Death by Neurologic Criteria.Alexander A. Kon - 2020 - American Journal of Bioethics 20 (6):30-32.
    Volume 20, Issue 6, June 2020, Page 30-32.
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  15.  33
    Shared decision making observed in clinical practice: visual displays of communication sequence and patterns.Glyn Elwyn, Adrian Edwards, Michel Wensing, Richard Hibbs, Clare Wilkinson & Richard Grol - 2001 - Journal of Evaluation in Clinical Practice 7 (2):211-221.
  16.  12
    Shared decision making, prospektive Lebensqualität und das beste Interesse des Kindes: ethische Herausforderungen im Kontext von Behandlungsentscheidungen bei Frühgeborenen an der Grenze der Lebensfähigkeit.Diana Carvalho & Nadia Primc - 2023 - Ethik in der Medizin 35 (4):487-506.
    Zusammenfassung Behandlungsentscheidungen bei Frühgeburten an der Grenze der Lebensfähigkeit stellen eine große Herausforderung dar. In der Neonatologie hat sich das Konzept einer prognostischen Grauzone etabliert, die als ein Grenzbereich verstanden wird, in dem sich aus medizinischer Sicht die Nutzen-Risiko-Abwägung aufgrund der unsicheren Prognose sehr schwierig gestaltet und sich aus ethischer Sicht sowohl eine kurative als auch eine palliative Versorgung prinzipiell rechtfertigen lassen. Innerhalb der Grauzone wird zumeist eine gemeinsame Entscheidungsfindung mit den Eltern in Form eines „shared-decision making (...)
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  17. Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research.Christian Munthe, Lars Sandman & Daniela Cutas - 2012 - Health Care Analysis 20 (3):231-249.
    This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues (...)
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  18.  10
    Shared Decision-Making and the Lower Literate Patient.David I. Shalowitz & Michael S. Wolf - 2004 - Journal of Law, Medicine and Ethics 32 (4):759-764.
    In recent years, shared decision-making has become entrenched in the medical literature and the law as the ideal method for involving patients in decisions related to their health care. Shared decision-making represents a compromise between the opposed extremes of paternalistic interactions that limit patients’ control of their health care, and “informed choice” interactions that require physicians to provide technical expertise only, leaving patients to make all treatment decisions on their own. An implicit goal of (...)
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  19.  5
    Shared Decision-Making and the Lower Literate Patient.David I. Shalowitz & Michael S. Wolf - 2004 - Journal of Law, Medicine and Ethics 32 (4):759-764.
    In recent years, shared decision-making has become entrenched in the medical literature and the law as the ideal method for involving patients in decisions related to their health care. Shared decision-making represents a compromise between the opposed extremes of paternalistic interactions that limit patients’ control of their health care, and “informed choice” interactions that require physicians to provide technical expertise only, leaving patients to make all treatment decisions on their own. An implicit goal of (...)
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  20.  75
    Shared decision making: evaluation of German medical students' preferences.Heide B. Schneider & Hagen Sandholzer - 2008 - Journal of Evaluation in Clinical Practice 14 (3):435-438.
  21.  31
    Shared decision making in rare diseases.Franziska Krause - 2019 - Ethik in der Medizin 31 (2):131-141.
    ZusammenfassungSeltene Erkrankungen stellen in vielerlei Hinsicht eine Herausforderung für unser Gesundheitssystem dar. Am deutlichsten wird dies in der Frage, wie Menschen mit einer seltenen Erkrankung eine gute Versorgung und der Zugang zu Forschung vor dem Hintergrund der niedrigen Prävalenz der meisten seltenen Erkrankungen ermöglicht werden kann. Auch auf der Ebene der Arzt-Patient-Beziehung weist der Umgang mit Menschen mit einer seltenen Erkrankung Besonderheiten auf, die es vor allem beim Shared Decision Making zu berücksichtigen gilt. An zwei aktuellen Beispielen, (...)
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  22.  6
    Shared Decision-Making and Relational Moral Agency: On Seeing the Person Behind the ‘Expert by Experience’ in Mental Health Research.Anna Bergqvist - 2023 - Royal Institute of Philosophy Supplement 94:173-200.
    The focus of this paper is the moral and scientific value of ‘expertise by experience’, that is, knowledge based on personal experience of ill mental health as a form of expertise in mental health research. In contrast to individualistic theories of personal autonomy and the first-person in bioethics, my account of shared decision-making is focussed on how a relational approach to the ‘person’ and ‘patient values’ can throw new light on our understanding of ‘voice’ in mental health (...)
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  23.  5
    Shared decision-making in patient–doctor consultations – How does it relate to other patient-centred aspects and satisfaction?Helene Bodegård, Gert Helgesson, Daniel Olsson, Niklas Juth & Niels Lynøe - 2022 - Clinical Ethics 17 (2):152-160.
    Background This study was designed to investigate how patient-reported shared decision-making relates to other aspects of patient centredness and satisfaction. Methods Questionnaire study with patients. Consecutive patients in primary care responding post visit. Associations are presented as proportions, positive predictive values, with 95% confidence intervals. Results 223 patient questionnaires were included. 62% : 55–69) of the patients indicated the highest possible rating of being involved in the decisions about their ongoing care. Self-reported SDM had a positive predictive (...)
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  24.  21
    Shared Decision-Making in Palliative Care: A Maternalistic Approach.Laura Sullivan, Mary Adler, Joshua Arenth, Shelly Ozark & Leigh Vaughan - 2021 - Narrative Inquiry in Bioethics 11 (2).
    During goals of care conversations, palliative care clinicians help patients and families determine priorities of care and align medical care with those priorities. The style and methods of communicating with families and negotiating a care plan can range from paternalistic to entirely patient driven. In this paper, we describe a case in which the palliative care clinician approached decision-making using a paradigm that is intuitive to many clinicians and which seems conceptually sound, but which has not been fully (...)
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  25.  24
    Shared DecisionMaking in Pediatrics: Honoring Multiple Voices.Daniel J. Benedetti - 2017 - Hastings Center Report 47 (4):46-47.
    Historically, parents looking for guidance turned to a small cadre of trusted individuals such as grandparents and pediatricians. In the Internet era, this paradigm has shifted. With a few keystrokes, anxious parents have access to a seemingly endless array of opinions from faceless sources with unknown agendas. For some parents, this can cause more uncertainty, and for the parents of a child with a medical condition, navigating this information can be overwhelming. In this modern paradigm, the pediatrician's duty has also (...)
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  26.  33
    Prudence in Shared Decision-Making: The Missing Link between the “Technically Correct” and the “Morally Good” in Medical Decision-Making.Paul Muleli Kioko & Pablo Requena Meana - 2021 - Journal of Medicine and Philosophy 46 (1):17-36.
    Shared Decision-Making is a widely accepted model of the physician–patient relationship providing an ethical environment in which physician beneficence and patient autonomy are respected. It acknowledges the moral responsibility of physician and patient by promoting a deliberative collaboration in which their individual expertise—complementary in nature, equal in importance—is emphasized, and personal values and preferences respected. Its goal coincides with Pellegrino and Thomasma’s proximate end of medicine, that is, a technically correct and morally good healing decision for (...)
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  27.  19
    Is Shared Decision Making an Appropriate Analytic Frame for Research on Medical Practices?Jeremy Sugarman - 2015 - American Journal of Bioethics 15 (9):18-20.
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  28. Shared decision making, truth-telling, and the recalcitrant family.John D. Lantos - 2021 - In The ethics of shared decision making. New York, NY: Oxford University Press.
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  29.  23
    Shared Decision Making in Dialysis: A New Clinical Practice Guideline to Assist with Dialysis-Related Ethics Consultations.Alvin H. Moss - 2001 - Journal of Clinical Ethics 12 (4):406-414.
  30.  22
    An ethical approach to shared decision-making for adolescents with terminal illness.Hunter Smith, Vivian Altiery De Jesús, Margot Kelly-Hedrick, Cami Docchio, Joy Piotrowski & Zackary Berger - 2023 - Clinical Ethics 18 (2):264-270.
    Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision- (...) triad that also includes the parents or guardians. The multifactorial nature of these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. (shrink)
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  31. Getting Obligations Right: Autonomy and Shared Decision Making.Jonathan Lewis - 2020 - Journal of Applied Philosophy 37 (1):118-140.
    Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the (...)
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  32. Shared decision making: The ethics of caring and best respect.J. E. Beltran - 1996 - Bioethics Forum 12 (3):17-25.
     
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  33.  23
    Health-care needs and shared decision-making in priority-setting.Erik Gustavsson & Lars Sandman - 2015 - Medicine, Health Care and Philosophy 18 (1):13-22.
    In this paper we explore the relation between health-care needs and patients’ desires within shared decision-making in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries (...)
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  34.  49
    The Ideal of Shared Decision Making Between Physicians and Patients.Dan W. Brock - 1991 - Kennedy Institute of Ethics Journal 1 (1):28-47.
    In lieu of an abstract, here is a brief excerpt of the content:The Ideal of Shared Decision Making Between Physicians and PatientsDan W. Brock (bio)IntroductionShared treatment decision making, with its division of labor between physician and patient, is a common ideal in medical ethics for the physician-patient relationship.1 Most simply put, the physician's role is to use his or her training, knowledge, and experience to provide the patient with facts about the diagnosis and about the (...)
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  35.  11
    What constitutes fair shared decisionmaking in global health research collaborations?Bridget Pratt - 2020 - Bioethics 34 (9):984-993.
    Funders (located primarily in high‐income countries) and high‐income country researchers have historically dominated decisionmaking within global health research collaborations: from setting agendas and research design to determining how data are collected and analysed and what happens with findings and outputs. The ethical principle of shared decisionmaking has been proposed as a way to help address these imbalances within collaborations and to reduce semicolonial and exploitative forms of global health research. It is important to be clear (...)
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  36.  21
    Prudent evidence‐fettered shared decision making.Elizabeth Libby Bogdan-Lovis & Margaret Holmes-Rovner - 2010 - Journal of Evaluation in Clinical Practice 16 (2):376-381.
  37.  13
    Autonomy and paternalism in shared decisionmaking in a Saudi Arabian tertiary hospital: A cross‐sectional study.Yousef Y. Alabdullah, Esra Alzaid, Safa Alsaad, Turki Alamri, Saleh W. Alolayan, Suliman Bah & Abdullah S. Aljoudi - 2023 - Developing World Bioethics 23 (3):260-268.
    Medical paternalism has long been a common medical practice. However, patient autonomy in healthcare has been recently adopted by doctors and patients alike. This study explored whether doctors and patients in a tertiary care hospital in Saudi Arabia preferred autonomy or paternalism in shared decisionmaking. A total of 118 participants (51 patients requiring total knee replacement, owing to stages 3–4 of osteoarthritis, and 67 doctors) from the Eastern province, Saudi Arabia. responded to a 17‐question category‐based questionnaire involving (...)
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  38. Cross-Cultural Interactions and Shared Decision-Making.Sabrina F. Derrington & Erin Paquette - 2021 - In John D. Lantos (ed.), The ethics of shared decision making. New York, NY: Oxford University Press.
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  39.  27
    Discussion and shared decision-making in a 'State Of Permanent Distress'.Concepcion Prados, Elisabet Martinez-Ceron, Javier Barbero, Ana Santiago & Rodolfo Alvarez-Sala - 2013 - Clinical Ethics 8 (1):35-37.
    It is the case of a 66-year-old man in a permanent vegetative state which his family is blocked due to suffering. A process and a document of a shared decision-making between the family and the professional team allowed giving emotional support, unlocking the situation and preventing complicated grief.
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  40.  21
    The ethics of shared decision making.John D. Lantos (ed.) - 2021 - New York, NY: Oxford University Press.
    There are some paradoxes in the way doctors and patients make medical decisions today. Today's patients are more empowered than were patients in the past. They have the right to see their medical records. The law requires doctors to obtain their informed consent for treatment. Patients are told about the options for treatment and the risks and benefits of each option. Their values and preferences are elucidated in order to guide the treatments that are provided.
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  41.  30
    How shared is shared decision-making? A care-ethical view on the role of partner and family.Inge van Nistelrooij, Merel Visse, Ankana Spekkink & Jasmijn de Lange - 2017 - Journal of Medical Ethics 43 (9):637-644.
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  42.  37
    The Concept of Negotiation in Shared Decision Making.Lars Sandman - 2009 - Health Care Analysis 17 (3):236-243.
    In central definitions of shared decision-making within medical consultations we find the concept of negotiation used to describe the interaction between patient and professional in case of conflict. It has been noted that the concept of negotiation is far from clear in this context and in other contexts it is used both in terms of rational deliberation and bargaining. The articles explores whether rational deliberation or bargaining accurately describes the negotiation in shared decision-making and (...)
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  43.  24
    Legal briefing: Shared decision making and patient decision aids.T. M. Pope & M. Hexum - 2013 - Journal of Clinical Ethics 24 (1):70-80.
    This “Legal Briefing” column covers recent legal developments involving patient decision aids. This topic has been the subject of recent articles in JCE. It is included in the 2010 Patient Protection and Affordable Care Act. And it has received significant attention in the biomedical literature, including a new book, a thematic issue of Health Affairs, and a recent article in the New England Journal of Medicine. Moreover, physicians and health systems across the United States are increasingly integrating decision (...)
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  44.  61
    Deciding Together? Best Interests and Shared Decision-Making in Paediatric Intensive Care.Giles Birchley - 2014 - Health Care Analysis 22 (3):203-222.
    In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable (...)
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  45.  15
    Exploring the Role of Shared Decision Making in the Consent Process for Pediatric Genomics Research in Cameroon, Tanzania, and Ghana.Daima Bukini, Jantina deVries, Marsha Treadwell, Kofi Anie, Jemima Dennis-Antwi, Karene Kengne Kamga, Sheryl McCurdy, Kwaku Ohene-Frempong, Julie Makani & Ambroise Wonkam - 2019 - AJOB Empirical Bioethics 10 (3):182-189.
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  46.  25
    Re-engineering shared decision-making.Muriel R. Gillick - 2015 - Journal of Medical Ethics 41 (9):785-788.
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  47.  17
    The Potential of Shared Decision Making to Reduce Health Disparities.Jaime S. King, Mark H. Eckman & Benjamin W. Moulton - 2011 - Journal of Law, Medicine and Ethics 39 (s1):30-33.
    Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...)
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  48.  26
    The Potential of Shared Decision Making to Reduce Health Disparities.Jaime S. King, Mark H. Eckman & Benjamin W. Moulton - 2011 - Journal of Law, Medicine and Ethics 39 (s1):30-33.
    Current methods of obtaining an informed consent leave much to be desired. Patients rarely read consent forms or understand all of the risks, benefits, or alternatives associated with their treatment. Evaluating the advantages and disadvantages of treatment options often presents a more significant challenge for patients with lower levels of health literacy. This article reviews the evidence of shortcomings in our informed consent system and then explores the potential for a new approach to engage patients at all levels of health (...)
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  49.  35
    Autonomy: What's Shared Decision Making Have to Do With It?Peter A. Ubel, Karen A. Scherr & Angela Fagerlin - 2018 - American Journal of Bioethics 18 (2):11-12.
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  50.  35
    Artificial intelligence and the doctor–patient relationship expanding the paradigm of shared decision making.Giorgia Lorenzini, Laura Arbelaez Ossa, David Martin Shaw & Bernice Simone Elger - 2023 - Bioethics 37 (5):424-429.
    Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI‐based CDSS has an impact on the doctor–patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor–patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI‐based CDSS for shared (...)making to better comprehend its promises and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor–patient communication is essential to promote more ethical medical practice. Both doctors' and patients' autonomy need to be considered in the light of AI. (shrink)
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