Shared decision-making and patient autonomy

Theoretical Medicine and Bioethics 30 (4):289-310 (2009)
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Abstract

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 shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

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Christian Munthe
University of Gothenburg

References found in this work

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - New York: Oxford University Press.
Utilitarianism: For and Against.J. J. C. Smart & Bernard Williams - 1973 - Cambridge: Cambridge University Press.
Creating the Kingdom of Ends.Christine M. Korsgaard - 1996 - Cambridge University Press.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Cambridge University Press.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Philosophy 64 (250):571-572.

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