Blair Louisa, Légaré France
Department of Practical Theology, Faculté de théologie et de sciences religieuses, Université Laval, Pavillon Félix-Antoine-Savard, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
Canada Research Chair in Implementation of Shared Decision Making in Primary Care, Université Laval, Quebec City, Canada.
Patient. 2015 Dec;8(6):471-6. doi: 10.1007/s40271-015-0117-0.
The idea of shared decision making (SDM) between patient and physician grew out of a generalized challenge to traditional social hierarchies that occurred in the middle of the last century. Governments have espoused SDM, thousands of articles about it have been published, and evidence has shown that it improves some of the healthcare processes as well as patient outcomes. Yet it has not been widely adopted. From their cross-disciplinary perspective (practical theology and clinical medicine), the authors locate this reluctance in the unfolding of scientific paradigm shifts, summarize the perceived risks and benefits of SDM and the evidence for each, and suggest practical, achievable approaches for clinicians. Finally, they explore some important emerging territories for SDM.
患者与医生之间共同决策（SDM）的理念源于上世纪中叶对传统社会等级制度的普遍挑战。政府支持共同决策，数千篇相关文章已发表，且有证据表明它能改善一些医疗过程以及患者的治疗效果。然而，它尚未得到广泛应用。作者从跨学科视角（实践神学和临床医学）出发，将这种不情愿归因于科学范式转变的发展过程，总结了共同决策的感知风险和益处以及各自的证据，并为临床医生提出了切实可行的方法。最后，他们探索了共同决策一些重要的新兴领域。
