Shared decision-making in health care: Achieving evidence-based patient choice

Abstract

Abstract The relationship between a patient and their health professional is viewed as one of the most complex interpersonal relationships. It involves the interaction between people in unequal positions, often non-voluntary, often addressing vitally important issues, emotionally laden, and requiring close co-operation (Ong et al., 1995). It has also long been recognized as a vital influence on the course of illness: Hippocrates observed that ‘some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician’ (Heritage and Maynard, 2006). There is a long history of studying the doctor–patient relationship in social sciences with seminal work from several authors, identifying the importance of the ‘sick role’ for the patient (Parsons, 1951), but also how doctor-centred behaviours attenuate therapeutic possibilities (Byrne and Long, 1976), and how the extent to which patients adopt passive roles and accept medical expertise and authority vary with the character time scale and severity of their illness and its treatment or options for self-treatment (Szasz and Hollander, 1956).