Patient participation

Shared decision making is a concept in medical care where doctors explain treatments and alternatives to patients, and patients choose the course of action most in keeping with their unique personal and cultural preferences. This is in contrast with the paternalistic model of medical decision making, where up until the 1990s, 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 strengthened patient autonomy as a critical component of medical ethics, and shared decision making stems from giving patients more say 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. Many times, there is not only 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.