Intended for healthcare professionals

Letters Stop sitting on the fence

Shared decision making asks patients to share their aims and values for treatment

BMJ 2014; 348 doi: (Published 12 February 2014) Cite this as: BMJ 2014;348:g1435
  1. David W Hamilton, ear, nose, and throat registrar1
  1. 1Newcastle University and Freeman Hospital, Institute of Health and Society, University of Newcastle, Newcastle NE2 4AX, UK
  1. david.hamilton{at}

The central assertion of Sarela’s article is that doctors should provide a clear recommendation to guide decision making.1 This is correct—the treatment recommendation is an essential part of a shared decision. However, elsewhere he asserts that medical decisions are often so complex that informed decision making by patients is “almost always impossible,” and he …

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