Shared Decision Making

Shared decision making ensures that individuals are supported to make decisions that are right for them. It is a collaborative process through which a clinician supports a patient to reach a decision about their treatment.

The conversation brings together:

the clinician’s expertise, such as treatment options, evidence, risks and benefits
what the patient knows best: their preferences, personal circumstances, goals, values and beliefs.

Shared decision making requires skill from health professionals and most importantly a willingness to involve people in decisions about their own care. Health professionals also need to recognise that patients, particularly those with lower levels of health literacy, may need support to take a more active partnership role with their care professional. To be successful, it relies on two sources of expertise:

the health professional as an expert on the effectiveness, probable benefits and potential harms of treatment options
the person as an expert on themselves, their social circumstances, attitudes to illness and risk, values and preferences.

In any decision where there is more than one option, the values and preferences of the person, such as their attitude to risk, may be as important as the clinical evidence in choosing which option to follow. Shared decision making enables people to align their preferences to treatment options that are clinically valid. It does not mean that people can choose clinical treatments that have no evidence base. Both parties must be willing to share information and accept shared responsibility for joint decision-making. This may only be a subtle change of practice for some, but it could feel like a dramatic one for others and especially for the person involved.