Dual-degree MD and master of population health sciences candidate at Washington University School of Medicine in St Louis, Missouri.
Assistant professor of medicine in the Bioethics Research Center at Washington University School of Medicine in St Louis, Missouri.
AMA J Ethics. 2020 May 1;22(5):E416-422. doi: 10.1001/amajethics.2020.416.
Shared decision making (SDM) is a desirable process and outcome of patient-clinician relationships. Ideally, patients and clinicians have sufficient time to engage in SDM. In reality, time is often insufficient. This article explores time as a barrier to SDM, alternative ways clinicians can think about time, and steps they can take to have fulfilling SDM interactions despite time constraints. Although discussions of time typically focus on time quantity, redirecting attention to the ethical significance of time in establishing patient-clinician relationships suggests the importance of also considering time quality.
共享决策(SDM)是医患关系中理想的过程和结果。理想情况下,患者和临床医生有足够的时间参与 SDM。但实际上,时间往往是不够的。本文探讨了时间作为 SDM 的障碍,临床医生如何思考时间的替代方式,以及他们可以采取哪些步骤来在时间受限的情况下进行富有成效的 SDM 互动。尽管关于时间的讨论通常集中在时间数量上,但将注意力重新集中到时间在建立医患关系中的伦理意义上,表明了考虑时间质量的重要性。