BMJ 1999;319:766-771 ( 18 September )

Education and debate

    Framework for teaching and learning informed shared decision making
    Commentary: Competencies for informed shared decision making
    Commentary: Proposals based on too many assumptions

Framework for teaching and learning informed shared decision making

Angela Towle, director, MD undergraduate programme a,  William Godolphin, professor b. 

a Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada V5Z 4E3, b Department of Pathology and Laboratory Medicine, University of British Columbia

Correspondence to: A Towle atowle@interchange.ubc.ca

The first 150 words of the full text of this article appear below.

Patients should be involved in making decisions about their health care. The ethical imperative of autonomy is reflected in legal trends that require a high standard of disclosure for informed consent, amounting to a principle of informed choice.1-3 Outcomes of care and adherence to treatment regimens improve when patients are more involved. 4 5 Consumerism is part of the social spirit, and governments exhort citizens to take more responsibility.

Models of doctor-patient encounters that result in increased involvement of patients and that are informed by good evidence have been termed, for example, "informed patient choice"6-8 but do not describe the interactive process clearly. We use the term informed shared decision making to describe decisions that are shared by doctor and patient and informed by best evidence, not only about risks and benefits but also patient specific characteristics and values. It occurs in a partnership that rests on explicitly acknowledged rights and duties . . . [Full text of this article]
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