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Shared decision making and other stories . . .

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5574 (Published 17 September 2014) Cite this as: BMJ 2014;349:g5574

Shared decision making is a widely proclaimed ethical imperative in medicine, but patients don’t always show enthusiasm when asked to make their own treatment choices. And when they do, their processes are not the same as those of doctors, according to a Yale study of patients with rheumatoid arthritis who face an escalation in treatment (Rheumatology 2014, doi:10.1093/rheumatology/keu324). Patients with severe symptoms might see such symptoms as a strong reason to escalate care; equally, they might see them as a strong reason against extra treatment. Many were not willing to enter into discussion about these choices. By contrast, those who were moderately affected were more likely to consider treatment options but were often swayed by considerations outside the clinical domain.

Tightening of the foreskin is a common problem in European boys and traditionally has been treated by circumcision or prepuceplasty. But a new Cochrane review (Cochrane Database of Systematic Reviews 2014;9:CD008973, doi:10.1002/14651858.CD008973.pub2) serves to remind GPs who …

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