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Shared Decision-Making Principles in Healthcare


Shared decision making is an essential component of patient-centered healthcare. It is the process in which patients and health professionals work together to select treatments and healthcare plans and make decisions that balance the risks and expected outcomes with patients’ preferences and values (Bae, 2017). To provide effective care, healthcare workers need to understand the concepts relevant to shared decision making and follow the basic principles stipulated in the following bulletin.

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Benefits of Shared Decision Making

Shared decision making provides a number of benefits to both patients and health care professionals.

  • It increases patient satisfaction and leads to better health outcomes (Agency for Healthcare Research and Quality 2020).
  • Patients who are involved in choosing their treatment experience less anxiety and depression, quicker recovery, and increased compliance with treatment regimens (Agency for Healthcare Research and Quality 2020).
  • Greater patient involvement leads to the reduction of healthcare costs (Bae 2017).
  • It improves the quality of patient-physician communication, allowing people receiving and delivering care to understand what is important for other person, which improves both patients’ and doctors’ satisfaction (Agency for Healthcare Research and Quality 2020).

Principles of Shared Decision Making

For effective shared decision making, a number of principles need to be observed. First, patients need to be given extensive information about the possible choices. Many patients experience frustration and dissatisfaction with their care because they do not feel like they have adequate input into the decisions that their doctors make about their health (Agency for Healthcare Research and Quality 2020). They do not understand the evidence behind the decisions and do not have enough knowledge to evaluate the available treatment options. The solution is to share with the patients all available information about their care and make sure that they accurately understand it. Patient decision aids are instruments used to explain the issues fairly and, explain the pros and cons of each option, and provide support for patients require it.

Second, healthcare providers should be supportive of patient involvement in the decision-making process. Currently, some health professionals do not approve of patient involvement, while others support the concept but do not know how to put it into practice (Agency for Healthcare Research and Quality 2020). Relevant education should be provided to doctors and nurses to ensure that they can effectively communicate with patients and encourage them to make informed healthcare decisions (Bae 2017). They need to learn to ask questions corresponding to individual patient’s characteristics, extract relevant patient information from various sources, and collaborate with other health specialists to ensure effective care.

The third recommendation for efficient decision making pertains to end-of-life and palliative care. When treating patients with late-stage terminal diseases, health professionals need to choose between fighting to prolong their lives or giving up and keeping a patient comfortable (Talks at Google 2017). Dealing with mortality means to not giving a patient a good death but a good life up until the end, and the most important thing for health professionals is to find a compromise between quantity and quality of care.

The most important thing in providing end-of-life care is to determine a patient’s priorities and focus on them. Healthcare specialists usually give the utmost attention to prolonging an individual’s life without caring about what is important for them (Talks at Google 2017). Involving other goals besides surviving into the healthcare process includes providing palliative care to patients from the early stages of terminal illnesses.

Palliative care deals with improving the patient’s quality of life and focuses on goals rather than options. The studies show that the patients who started palliative care at the early stages of disease generally produce better outcomes. They are 90% less likely to be on chemotherapy in the last two weeks of their lives, and 50% less likely to start chemo during the last three months of their lives (Talks at Google 2017). They spend more time at home and are less likely to die in the hospital. They experience less suffering, including depression and anxiety, and, as a result, live 25% longer than patients who do not receive palliative care. The same principles can be applied to treating regular patients—pay more attention to their needs, values, and priorities to ensure effective care.

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The practice of shared decision making is based on several principles that should be implemented by doctors and nurses in healthcare facilities to provide effective care. The first is giving patients all possible information about available treatment options and ensuring that they fully understand them. The second is being supportive of patient involvement in the decision-making process. The third is focusing on an individual’s priorities and quality of life rather than on general surviving. These principles are particularly important in end-of-life care that generally gives more attention to options rather than goals. Listening to patients, determining their life priorities, and considering them facilitates shared decision making, increases patient satisfaction, and provides better health outcomes.


Agency for Healthcare Research and Quality. 2020. “Strategy 6I: Shared decisionmaking.” Web.

Bae, Jong-Myon. 2017. “Shared decision making: Relevant concepts and facilitating strategies.” Epidemiology and Health 39. Web.

Talks at Google. 2020. Being Mortal: Medicine and What Matters in the End. Atul Gawande. Talks at Google.” Web.

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