Chandrakantan Arvind, Saunders Tracie
Department of Anesthesiology, Institutional Ethics Committee, Stony Brook University Medical Center, HSC Level 4, Room # 060, Stony Brook, NY 11794, USA.
Department of Anesthesiology, Institutional Ethics Committee, Stony Brook University Medical Center, HSC Level 4, Room # 060, Stony Brook, NY 11794, USA.
Anesthesiol Clin. 2016 Mar;34(1):35-42. doi: 10.1016/j.anclin.2015.10.004.
Shared decision-making is a paradigm of patient engagement that is assuming greater importance in the era of value-based health care. The basic tenets include patient engagement on clinical decisions, taking into account multiple factors that influence physician and patient decision-making. Understanding and reconciling diametrically opposed views of care are important tenets of shared decision-making. Because many decisions are made preoperatively, the applicability of these principles may be useful especially in the situation of a higher risk surgical candidate. Many patients with Do-Not-Resuscitate (DNR) orders are undergoing procedures to improve quality of life. This article explores shared decision-making and DNR.
共同决策是患者参与的一种模式，在基于价值的医疗保健时代正变得越来越重要。其基本原则包括患者参与临床决策，同时考虑影响医生和患者决策的多种因素。理解并协调截然不同的医疗观点是共同决策的重要原则。由于许多决策是在术前做出的，这些原则的适用性可能特别有助于高风险手术候选患者的情况。许多签署了“不要复苏”（DNR）医嘱的患者正在接受改善生活质量的手术。本文探讨共同决策与DNR。
