Journal of Applied Philosophy 37 (1):118-140 (2020)

Jonathan Lewis
University of Manchester
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 ethical imperative of respecting patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy.
Keywords Shared Decision Making  Autonomy  Sovereignty  Capacity  Relational Autonomy  Recognition  Medical Decisions  Informed Consent
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Reprint years 2019, 2020
DOI 10.1111/japp.12383
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References found in this work BETA

Autonomy in Moral and Political Philosophy.John Christman - 2008 - Stanford Encyclopedia of Philosophy.
Shared Decision-Making and Patient Autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
Autonomy in Medical Ethics After O'Neill.G. M. Stirrat - 2005 - Journal of Medical Ethics 31 (3):127-130.

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Citations of this work BETA

Capturing and Promoting the Autonomy of Capacitous Vulnerable Adults.Jonathan Lewis - 2020 - Journal of Medical Ethics:medethics-2020-106835.

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Does Shared Decision Making Respect a Patient's Relational Autonomy?Jonathan Lewis - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1063-1069.
Shared Decision-Making and Patient Autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
Deciding for the Incompetent.Eric Vogelstein - 2017 - In John K. Davis (ed.), Ethics at the End of Life: New Issues and Arguments. New York: Routledge. pp. 108-125.


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