Framework for teaching and learning informed shared decision making
Framework for teaching and learning informed shared decision making
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DOI：
10.1136/bmj.319.7212.766
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发表时间：
1999-09-18
影响因子：
--
通讯作者：
Godolphin, W
中科院分区：
文献类型：
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作者：
Towle, A;Godolphin, W
病人应该参与决定他们的医疗保健。自主权的道德必要性反映在法律的趋势中，这些趋势要求对知情同意实行高标准的披露，相当于知情选择原则。1-3当患者更多地参与时，护理的结果和对治疗方案的依从性得到改善。4 5消费主义是社会精神的一部分，政府要求公民承担更多的责任。医生与病人接触的模式导致病人参与的增加，并有良好的证据，例如，被称为“知情的病人选择”6-8，但没有清楚地描述互动过程。我们使用“知情共享决策”一词来描述医生和患者共享的决策，这些决策不仅涉及风险和收益，而且涉及患者的具体特征和价值。它发生在一种基于明确承认的权利和义务以及对双方利益的期望的伙伴关系中。我们认为，参与知情共享决策的能力是一个特征，
Patients should be involved in making decisions about their health care. The ethical imperative of autonomy is reflected in legal trends that require a high standard of disclosure for informed consent, amounting to a principle of informed choice. 1–3 Outcomes of care and adherence to treatment regimens improve when patients are more involved. 4 5 Consumerism is part of the social spirit, and governments exhort citizens to take more responsibility.Models of doctor-patient encounters that result in increased involvement of patients and that are informed by good evidence have been termed, for example,“informed patient choice” 6–8 but do not describe the interactive process clearly. We use the term informed shared decision making to describe decisions that are shared by doctor and patient and informed by best evidence, not only about risks and benefits but also patient specific characteristics and values. It occurs in a partnership that rests on explicitly acknowledged rights and duties and an expectation of benefit to both. We propose that a demonstrated capacity to engage in informed shared decision making is charac-