ACOG recently updated its opinion on informed consent and shared-decision making. In the first part of this series, informed consent was reviewed. To summarize, informed consent focuses on an explanation of diagnosis, the nature and purpose of recommended interventions, treatment alternatives, and risks vs benefits of all options. The following is a summary of key considerations related to shared decision-making.
Shared decision-making is patient-centered with an individualized approach
Shared decision-making, compared to informed consent, focuses on the patient’s values, priorities, and culture
Elements of Shared Decision-Making
Shared decision-making should be introduced early in medical training while practitioners who have completed training can participate in continuing medical education
By incorporating the following five steps (note the SHARE acronym) into the decision-making process, a clinician can better personalize information about treatment options and improve a patient’s decision to make an autonomous decision
Seek your patient’s participation
Help your patient explore and compare treatment options
Assess your patient’s values and preferences.
Reach a decision with your patient
Evaluate your patient’s decision
The Goals of Shared Decision Making
The goals of shared decision-making include
Increasing patients’ engagement in their medical care
Strengthen the therapeutic relationship with their healthcare professional
Key Points for Both Informed Consent and Shared Decision Making
An adult patient with decision-making capacity has the right to refuse treatment, including during pregnancy, labor, and delivery and when treatment is necessary for the patient’s health or survival, that of the patient’s fetus, or both
Healthcare professionals should view patient autonomy as relational because a patient brings interpersonal relationships and social environment to the discussion
Decision aids such as printed materials or videos can facilitate but not never substitute for provider information
Note: See the companion entry on informed consent in ‘ObG Related Topics’ below
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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