Chapter

Achieving shared treatment decisions

Martin H.N. Tattersall and David W. Kissane

in Oxford Textbook of Communication in Oncology and Palliative Care

Second edition

Published on behalf of Oxford University Press

Published in print February 2017 | ISBN: 9780198736134
Published online February 2017 | e-ISBN: 9780191799884 | DOI: https://dx.doi.org/10.1093/med/9780198736134.003.0014

Series: Oxford Textbooks in Palliative Medicine

Achieving shared treatment decisions

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The respect of a patient’s autonomous rights within the model of patient-centred care has led to shared decision-making, rather than more paternalistic care. Understanding patient needs, preferences, and lifestyle choices are central to developing shared treatment decisions. Patients can be prepared through the use of question prompt sheets and other decision aids. Audio-recording of informative consultations further helps. A variety of factors like the patient’s age, tumour type and stage of disease, an available range of similar treatment options, and their risk-benefit ratios will impact on the use of shared decision-making. Modifiable barriers to shared decision-making can be identified. Teaching shared decision-making includes the practice of agenda setting, use of partnership statements, clarification of patient preferences, varied approaches to explaining potential treatment benefits and risks, review of patient values and lifestyle factors, and checking patient understanding–this sequence helps both clinicians and patients to optimally reach a shared treatment decision.

Chapter.  6668 words. 

Subjects: Palliative Medicine ; Medical Oncology

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