Shared Decision-Making: Perspectives from a Patient, a Doctor & an Ethicist

What is Shared Decision-Making in healthcare? How does one engage in it? Can one choose not to participate? Is it even feasible in real life?

The CENTRES team at the NUS Centre for Biomedical Ethics presents - a doctor, a patient, and an ethicist, sharing their perspectives on these very questions and more. This engaging conversation delves into the fundamentals and complexities in Shared Decision-Making (SDM), a collaborative process in healthcare which best supports patients and clinicians in arriving at decisions together.

Chapters

Title and Introduction - 00:00
SDM for patients with chronic conditions - 11:11
The Confident Patient and different conceptions of decision-making - 22:01
Treatment options - 26:34
Strategies for discussing treatment options through SDM (table) - 31:45
Challenges and solutions - 31:53

Meet our Panel

Dr Yew Tong Wei is a Senior Consultant at the Division of Endocrinology, National University Hospital, and Assistant Professor at NUS Medicine. He is passionate about person-centred care and has pioneered care models that enable care that is truly respectful of, and responsive to, individual patient preferences, needs and values. He chairs the NUHS Patient and Family Advocacy Council.

Mr Ellil Mathiyan Lakshmanan is a double cancer survivor and an award-winning patient advocate. He is passionate about providing psychosocial support to other patients and working with healthcare professionals, teams, and institutions to improve outcomes and amplify patients' and caregivers' voices. He is also Co-founder and current president of the Ostomy Association of Singapore, and additionally holds leadership and consultative roles in numerous advocacy networks and healthcare institutions.

Dr Sumytra Menon is Deputy Director of NUS CBmE and Co-Director of the CENTRES initiative, instituted to develop educational activities in clinical and transplant ethics and enhance ethics committees’ capabilities. She is also CBmE’s Co-Director of Education and the Programme Director of Science, Health and Policy-relevant Ethics in Singapore (SHAPES). A lawyer by training, her particular research interests are in healthcare decision-making, mental capacity law, and end-of-life issues.

Suggested References

Charles, C., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Social science & medicine , 44(5), 681–692.
Legare, F., & Thompson-Leduc, P. (2014). Twelve myths about shared decision making. Patient Education & Counseling 96(3):281-286.
Cribb, A., & Entwistle, V. A. (2011). Shared decision making: trade-offs between narrower and broader conceptions. Health expectations : an international journal of public participation in health care and health policy 14(2), 210–219.
Levinson, W., Kao, A., Kuby, A., & Thisted, R. A. (2005). Not all patients want to participate in decision making. A national study of public preferences. Journal of general internal medicine 20(6), 531–535.
Menon, S., et al (2020). Some Unresolved Ethical Challenges in Healthcare Decision-Making: Navigating Family Involvement. Asian Bioethics Review 12, 27–36.
Coulter, A., et al. (2017). Shared decision making in the UK: Moving towards wider uptake. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen 123-124, 99–103.
Park, M., et al. (2024). Decision aids for promoting shared decision-making: A review of systematic reviews. Nursing & health sciences 26(1), e13071.
Glyn, E., Adrian Edwards, A., & Thompson, R., (eds.). Shared Decision Making in Health Care: Achieving evidence-based patient choice 3rd edn (Oxford, 2016).

#shareddecisionmaking #patientadvocacy #doctorpatientrelationship #healthcareethics

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