Shared Decision Making in Cancer Screening and Treatment Decisions for American Indian and Alaska Native Communities: Can We Ethically Calibrate Interventions to Patients' Values?

• Published in: Journal of cancer education 2012-12, Vol.27 (4), p.790-792
• Main Authors: Nowakowski, Katherine E., Tilburt, Jon C., Kaur, Judith S.
• Format: Article
• Language: English
• Subjects: Acculturation; Alaska; Alaska Natives; Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Community Relations; Cultural Diversity; Cultural values; Decision Making; Delivery of Health Care; Delivery Systems; Early Detection of Cancer - psychology; Evaluation Research; Evidence; Health Services; Humans; Indians, North American - psychology; Internal Medicine; Medical screening; Native North Americans; Neoplasms - diagnosis; Neoplasms - prevention & control; Neoplasms - psychology; Oncology; Patient care planning; Patients; Pharmacology/Toxicology; Physician Patient Relationship; Practice Patterns, Physicians; Quality of Health Care; Reflections; Screening Tests; Tribes; Values
• ISSN: 0885-8195; 1543-0154
• DOI: 10.1007/s13187-012-0412-6

Shared decision making has been advocated as a key ethical strategy to improve quality of care and cancer control, especially in relation to screening and treatment decisions at various stages of the cancer continuum. Recent research on cancer in American Indian/Alaska Native (AI/AN) communities has highlighted significant disparities, raising questions about how best to implement prevention and screening programs in often fragmented and underfunded Indian health, tribal and urban systems. Incorporating shared decision making initiatives routinely may provide opportunities to address the complex choices AI/AN patients face.