Shared and supported decision-making

Shared decision-making in palliative care is where a healthcare professional and a person work together to reach a decision(s) about care. If the person requires specific support to be able to contribute then this is referred to as supported decision-making.

In either case, ideally it involves choosing investigations and treatments based on the person's preferences, beliefs, and values, and the best available evidence.

Why it matters

Shared decision-making empowers people to make decisions about the treatment and care that is right for them at that time. This includes choosing to continue with their current treatment, change their treatment or choose no treatment at all. This can include the risks, benefits, and possible consequences of different options, and practical implications of each option (e.g. cost, time, travel etc.)

In practice

Nurses are well placed to work with and support patients to make care decisions that reflect their needs and preferences.

Patient decision aids

Patient decision aids are tools designed to help people take part in decision-making. They provide information on the healthcare options and help people to think about, clarify and communicate the value of each option to them personally. Patient decision aids do not advise people to choose one option over another, nor are they meant to replace healthcare professional consultation. Instead, they support people to make informed, values-based decisions with their healthcare professional.

Supported decision-making

All adults have an equal right to make decisions that affect their life and to have those decisions respected. A person's right to make decisions is fundamental to their independence and dignity.

There are situations where a person has capacity but needs help in making a decision. For example, a person with dementia, an intellectual disability, a communication disability, or a mental illness.