Shared Decision Making: Misconstrued and Misused

Shared decision making is widely promoted as the preferred model for communication between health care providers and patients when discussing recommended treatments or interventions. The concept of shared decision making is based on the tenets that patient autonomy is an ethical imperative, and several important outcomes of care are improved when individuals feel involved in their own health care decisions.2, 3 However, shared decision making can be misconstrued and therefore misused. Descriptions and definitions of shared decision making refer to the process as a model of patient‐centered care. This model is preferred when the patient is a candidate for the recommended treatment and the treatment choices are preference‐sensitive, meaning more than one option is clinically appropriate and expected to generate equivalent outcomes. In this situation, also known as equipoise, the patient's preferences should determine the ultimate choice of action. What could possibly be misunderstood here? Respecting goals, values, and preferences sounds like a synonym for patient‐centered care and a natural form of communication between midwives and the individuals we care for. However, shared decision making is actually a more nuanced process, and these nuances have important clinical ramifications. During a shared decision‐making process, both partners share information and collaborate in making the decision.