'Shared decison-making': als de dokter patiënt wordt

It was when a patient with a type A aortic dissection refused surgical treatment that our eyes were opened to the importance of shared decision-making (SDM). As these patients are usually transferred to the operating theatre without any opportunity for discussion about the indication for surgery, our department of cardiothoracic surgery rapidly became keen on applying the principles of SDM to all our patient contacts - as did other departments in our hospital. However, when I became a patient myself and was invited by my physicians to take part in the decision-making process about my treatment, I was surprised to find that I felt very reluctant to do so and preferred to be not involved at all. The various reasons I raised to explain this unexpected behaviour made good sense. Consequently, in my daily practice if a patient evidently does not want to take part in SDM, I now compassionately offer to make decisions myself without requiring their involvement.