[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Behavioral science](https://durgical.com/en/behavioral-science/) › [Doctor–patient relationship and communication](https://durgical.com/en/behavioral-science/areas/communication/) › Shared decision-making # Shared decision-making - Technique When there is more than one reasonable option, patient and clinician compare them and choose together according to the patient's values. Updated Nov 5, 2026 ## Key points - Used when options are in equipoise and the best one depends on what the patient values. - Three moments: introduce that there is a choice, explain the options and decide together. - Decision aids increase knowledge, improve risk perception and reduce decisional conflict. - Risks are given as absolute numbers and natural frequencies, ideally with icon arrays. - Ask how much the patient wants to take part: not everyone wants the same role. ## What it is Shared decision-making is a communication process in which the clinician brings the evidence on options, benefits and harms, and the patient brings their values, preferences and circumstances. It is most useful in preference-sensitive decisions, where no option is clearly better. A widely used scheme splits it into three conversations: introducing the choice, describing the options and reaching the decision. The ethical and legal aspects of consent are covered in another section. ## Key facts - Typical examples: prostate cancer screening with prostate-specific antigen, breast-conserving surgery versus mastectomy in early breast cancer, options in chronic disease. - Shared decision-making sits between paternalism and the purely informative model, close to Emanuel's deliberative model. - Greater physician empathy goes with more shared decision-making and less regret. - Barriers: time, low health literacy, language and cultural differences, and the clinician's belief that the patient does not want to take part. ## How it is done - Introduce the choice: ‘There is more than one reasonable way forward, and your view matters’. - Ask what they know and how much they want to be involved in the decision. - Describe each option, including watchful waiting, with benefits and harms in absolute numbers. - Use a decision aid if one exists (leaflet, icon array, comparison table). - Explore values: ‘What matters most to you in choosing?’ - Check understanding with teach-back. - Decide together, or agree a time frame to decide and whom to consult. - Revisit the decision at follow-up. ## Memory aid ‘There are options, here they are, what matters to you?’: three sentences that sum up the three conversations. ## Test yourself Think of the answer, then tap the question to see it. ## When is shared decision-making especially indicated? When there are several reasonable options with none clearly better, and the choice depends on the patient's values and preferences. ## What are the three conversations of the most used model? Introducing that there is a choice, describing the options with their benefits and harms, and reaching the decision. ## What effect do decision aids have? They increase knowledge, make risk perception more accurate and reduce decisional conflict. ## Why are risks given as absolute numbers? They are easier to understand and do not exaggerate the effect as relative risk does; for example, ‘2 in 100 versus 1 in 100’. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/behavioral-science/shared-decision-making/) ## Elsewhere in DurgiPedia - [The medical interview: rapport, open questions and listening](https://durgical.com/en/clinical-exam/the-medical-interview-rapport-open-questions-and-listening/) ## Connections ## Related 5 - [Models of the doctor–patient relationship and patient-centred care](https://durgical.com/en/behavioral-science/models-of-the-doctor-patient-relationship-and-patient-centred-care/) - [Health literacy](https://durgical.com/en/behavioral-science/health-literacy/) - [Communication skills: open questions, empathy and teach-back](https://durgical.com/en/behavioral-science/communication-skills-open-questions-empathy-and-teach-back/) - [Culture, explanatory models and interpreters](https://durgical.com/en/behavioral-science/culture-explanatory-models-and-interpreters/) - [Adherence: what it is and why it fails](https://durgical.com/en/behavioral-science/adherence-what-it-is-and-why-it-fails/) ## Related conditions 2 - [Prostate cancer](https://durgical.com/en/conditions/prostate-cancer/) - [Breast cancer](https://durgical.com/en/conditions/breast-cancer/) [← All of behavioral science](https://durgical.com/en/behavioral-science/) Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline. Sources: [Communication in Cancer Care (PDQ®)–Health Professional Version](https://www.cancer.gov/about-cancer/coping/adjusting-to-cancer/communication-hp-pdq) (National Cancer Institute (US), 2025); [Talking With Your Doctor: MedlinePlus](https://medlineplus.gov/talkingwithyourdoctor.html) (National Library of Medicine (US), 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/behavioral-science/shared-decision-making/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/behavioral-science/shared-decision-making/