When is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter

We consider whether there are situations in which `shared decision making' in primary care is inherently problematic, such as in the demand for antibiotics to treat viral disorders. In such an instance there might be a lack of the equipoise necessary for a decision-making context in which appar...

Full description

Saved in:
Bibliographic Details
Published in:Social science & medicine (1982) 1999-08, Vol.49 (4), p.437-447
Main Authors: Gwyn, Richard, Elwyn, Glyn
Format: Article
Language:English
Subjects:
Bioethics
Biological and medical sciences
Consultation
Cooperation
Decision Making
Dissent and Disputes
Family Practice
Female
General practitioners
Group Processes
Health participants
Humans
Infant
Infants
Male
Medical Decision Making
Medical sciences
Parents
Parents & parenting
Patient Participation
Patient Satisfaction
Patients
Pediatrics
Physicians
Power
Power (Psychology)
Practitioner Patient Relationship
Primary care
Professional-Family Relations
Public health. Hygiene
Public health. Hygiene-occupational medicine
Shared
Shared decision-making
Shared decision-making Primary care Treatment preferences
Tonsillitis
Tonsillitis - diagnosis
Tonsillitis - drug therapy
Treatment preferences
Withholding Treatment
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We consider whether there are situations in which `shared decision making' in primary care is inherently problematic, such as in the demand for antibiotics to treat viral disorders. In such an instance there might be a lack of the equipoise necessary for a decision-making context in which apparent choices are genuine options. Using the techniques of discourse analysis on the transcript of a consultation with the parents of an infant with tonsillitis, we illustrate how a general practitioner's (GP's) efforts to reach a `shared decision' come unstuck through a combination of the embedded power imbalance and the conflict between the GP's own prescription preferences and those of the parent.
ISSN:0277-9536
1873-5347
DOI:10.1016/S0277-9536(99)00067-2