Shared decision-making and patient autonomy |
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Authors: | Lars Sandman Christian Munthe |
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Institution: | 1.Department of Philosophy, Linguistics and Theory of Science,Gothenburg University,Gothenburg,Sweden;2.School of Health Sciences,University College of Bor?s,Bor?s,Sweden |
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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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