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Problems, Process, Progress

Robert A. McNutt, MD

JAMA. 2004;292:2516-2518.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

It is easy to march behind the banner of shared medical decision making. Sharing with a patient who faces tough choices when he or she is ill is one of the true gifts of being in the medical profession. The patient-physician relationship is the sacrosanct epitome of professionalism with the goals of ensuring that patients receive the treatment best for them (science) and that the best treatment is carried out in the most efficient and compassionate manner (quality and safety).

However, the concept of shared decision making requires careful consideration of several problems. The first problem is that the term "shared decision" is a misnomer. Consider the example of sharing toys between children: first one child plays, then the toy is passed on to the next child. This concept of sharing in the case of medical decision making between patient and physician, would not be possible. . . . [Full Text of this Article]

Author Affiliation: Department of Medicine, Rush University School of Medicine, Chicago, Ill. Dr McNutt is also Contributing Editor, JAMA.

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