Shared decision making

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. By being involved in the process, they may hope to achieve a treatment plan which is most in keeping with their needs and priorities. People may choose not to be involved, and to leave some (or all) decisions to health care professionals. However if people do not feel they have been involved when they would have wanted to, they may feel less in control and may regret the decisions made.

Reassurance and feeling informed

Discussing their options and preferences with health professionals enables people to understand their choices and feel they had made a decision which is right for them. 

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When people want to be involved it does not necessarily mean that they do not value the expert opinion of their clinical team. Health professionals are often seen as a reliable source of advice when decisions have to be made. When people share the decision with a professional they may feel more at ease with their decisions and feel confident they have made the ‘right’ choices.

Health professionals are sometimes willing to tell their patients what they would do faced with similar dilemmas. This can be seen as a piece of information which forms part of the picture, rather than an indication that they should do the same. Knowing what the health professional would choose, and why, can help patients feel reassured with the choices they make.

Tailoring treatment choices to the individual

People have unique experiences, beliefs, and priorities. Sharing decisions allows health professionals to take these experiences into account. Individuals also have knowledge of themselves apart from their “illness.” When people have a long term condition which they have gained expertise in managing, they have knowledge about the illness and how it affects them including the impact of treatments and side effects. Sharing decisions allows health professionals to take all of this knowledge and experience into account.

A woman with chronic pain advises others to do research and be prepared to be involved in decision making.

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Taking account of individual preferences

There are many aspects of people’s lives that doctors will not know about. These include how people balance length of life and quality of life, avoidance of specific effects of medicines, their views of invasive interventions and their moral views. For example, peoples religious beliefs may influence the healthcare decisions which people make, and doctors cannot know or guess what these will be, without asking or listening. 

Patients whose preferences were acknowledged described satisfaction with the treatment decision. The following two women describe different experiences when discussing their HRT, and different satisfaction with the result of this.

Patients may be involved in finding out about new treatments becoming available, and then be supported in accessing these.

Patients were sometimes aware that they were being asked to share in a decision because there was little research evidence about what the outcomes of treatment might be, or when there was media controversy surrounding the issue.

Sometimes patients’ choices may seem to clash with what health professionals are expecting or advising. In this case, patient input is needed to achieve the outcome they desire. The following clip describes a woman’s experience of this kind of situation. 

Involvement and control

Being involved in decision making with health professionals was important to some people because they want to keep the sense that they were in control. Being involved in decisions could feel empowering.

Having input into the decision whether to go ahead, delay or refuse treatment can be important to people. People who felt they had been excluded, or not fully informed, in the decision making process sometimes regretted what had happened to them or were dissatisfied with the final decision.

Last reviewed February 2016
Last updated February 2014


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