Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model

Cathy Charles, Amiram Gafni and Tim Whelan

Social Science & Medicine, 1999, vol. 49, issue 5, 651-661

Abstract: In this paper we revisit and add elements to our earlier conceptual framework on shared treatment decision-making within the context of different decision-making approaches in the medical encounter (Charles, C., Gafni, A., Whelan, T., 1997. Shared decision-making in the medical encounter: what does it mean? (or, it takes at least two to tango). Social Science & Medicine 44, 681-692.). This revised framework (1) explicitly identifies different analytic steps in the treatment decision-making process; (2) provides a dynamic view of treatment decision-making by recognizing that the approach adopted at the outset of a medical encounter may change as the interaction evolves; (3) identifies decision-making approaches which lie between the three predominant models (paternalistic, shared and informed) and (4) has practical applications for clinical practice, research and medical education. Rather than advocating a particular approach, we emphasize the importance of flexibility in the way that physicians structure the decision-making process so that individual differences in patient preferences can be respected.

Keywords: Treatment; decision-making; Doctor-patient; relationship; Communication; Breast; cancer (search for similar items in EconPapers)
Date: 1999
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Citations: View citations in EconPapers (90)

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