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

Authors
Christian Munthe
University of Gothenburg
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.
Keywords Shared decision-making  Patient autonomy  Patient choice  Paternalism
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DOI 10.1007/s11017-009-9114-4
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References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - 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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Citations of this work BETA

Getting Obligations Right: Autonomy and Shared Decision Making.Jonathan Lewis - 2020 - Journal of Applied Philosophy 37 (1):118-140.
Does Shared Decision Making Respect a Patient's Relational Autonomy?Jonathan Lewis - 2019 - Journal of Evaluation in Clinical Practice 25 (6):1063-1069.

View all 24 citations / Add more citations

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