Correspondence on 'The limits of shared decision making by Elwyn et al: We call for a more nuanced approach

We read with interest the recent article by Elwyn and colleagues that addressed ‘The limits of shared decision making’ (Elwyn et al, p.1).1 Like the article’s authors, we identify as ‘strong advocates of shared decision-making (SDM)’ while recognizing some limits to its application (Elwyn et al, p.1).1 However, we find the article’s interpretation of SDM principles to be lacking in nuance on multiple fronts. SDM is an essential component of evidence-based medicine, which requires a ‘recognition that values and preferences are as important as evidence in determining optimal clinical decisions’ (Djulbegovic and Guyatt, p.194).2 SDM is at odds with unwanted paternalistic care, including clinical interactions wherein healthcare professionals may posture empathetically, but ultimately strive to ‘convinc[e] patients to follow their [authoritative] plans’ (Braschi et al, p.177).3 A growing literature furthermore addresses SDM’s centrality in the delivery of culturally responsive, trauma-informed healthcare...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Letters Source Type: research