What is shared decision making in healthcare?

Shared decision making in healthcare is where a patient and healthcare professional make important decisions together that relate to the patient’s health.

Decisions often need to be made in healthcare. For example, you might need to decide:

• whether to have a particular test
• which treatment to choose from a range of options
• whether to have treatment or wait and see how your condition progresses

If you are pregnant, you may need to make decisions such as:

• which model of pregnancy care you would like
• where to have your baby
• whether to have a vaginal or caesarean birth
• which antenatal tests to have

In shared decision making, you and your doctor or midwife bring your perspectives to the discussion. Your doctor or midwife brings information and evidence about the benefits and disadvantages of different choices. You bring your values, goals, culture and circumstances. This helps you make the choice that is right for you.

If you have a partner, you may involve them as well.

Why is shared decision making important?

Shared decision making is ethical

Shared decision making is an ethical way to choose something. It means that you are involved in decisions that concern you.

Taking part in decisions about your health can make you happier with the care you get. You might also be more motivated to stick to the treatment that you choose.

Shared decision making considers what’s important to you

When you take part in the discussion, you’re able to express what’s important to you. You can choose the option that fits best with your values, desires and culture.

This is especially important with choices that you may have strong beliefs about. It’s also important with choices where the medical evidence doesn’t say clearly which is better or safer than the other.

You can also rule out options that might be difficult to access or too expensive for you.

Shared decision making gives you more knowledge

During shared decision making, your doctor or midwife will explain your choices. For each choice, they’ll tell you about the risks and benefits involved and how likely it is to be helpful or harmful for you. This will help you understand what to expect from the treatment you choose.

Sometimes, this may lead to you choosing a less invasive option. This may at times save unnecessary treatments and lower the costs involved.

What can you expect from your healthcare team?

As a patient in Australia, you can expect your treating team to respect your healthcare rights. The healthcare rights of all Australians are set out in the Australian Charter of Healthcare Rights. These rights apply to any healthcare you get, anywhere in Australia, including in public hospitals, private hospitals, general practice and in the community. You have a right to:

• be treated with respect
• be involved in making decisions about your health and include anyone you want
• be informed about your health conditions and any tests or treatments you are offered
• receive help understanding this information, if you need it
• ask your healthcare team any questions you may have

Your doctor or midwife might give you a decision aid. This is a paper or online resource that can help explain your options and get you to think about what’s important to you. If a decision aid is available for the choice you’re considering, it can be very helpful.

What if I don't agree with my healthcare team's recommendations?

You have a right to make decisions about your health without being pressured by others. This means that you are entitled to disagree with your doctor or midwife and choose not to have tests or treatments that they recommend.

Your doctor or midwife must respect your decision. They will be able to keep caring for you — you won’t need to switch healthcare providers.

However, to make sure that you are making a fully informed decision, your doctor or midwife might:

• check that you understand why they recommend the treatment
• check that you understand and accept the risks of not having the treatment
• ask you about your reasons for disagreeing, such as your beliefs or culture
• discuss alternative options with you
• make a note about it in your medical record and ask you to sign it

Can I get a second opinion?

Just like in any area of healthcare, you have a right to get a second opinion if you disagree with your doctor or midwife.

Who can I speak to if I'm not satisfied with my healthcare?

If you aren’t satisfied with your healthcare, there are many people you can speak to, including:

• your doctor or midwife
• the health complaints agency or health department in your local state or territory
• the Australian Health Practitioner Regulation Agency (AHPRA), if you have a concern about the unsafe behaviour or practice of a registered health practitioner
• the National Health Practitioner Ombudsman

If you aren’t sure about something that happened to you, especially during labour, birth or in an emergency, it’s a good idea to ask your doctor or midwife for a debrief. This is an opportunity to ask questions after an event, so that you better understand what happened.

Resources and support

You may find the following questions from Ask Share Know helpful when speaking to your doctor or midwife:

• What are my choices? (One choice will always be wait and watch)
• What are the possible benefits and risks of those choices?
• How likely will each benefit and risk happen to me?

You can visit the Ask Share Know website for more information and questions to help empower you to be involved in your health decisions.

If you want to know more about how decision aids can help, look at this resource about screening tests for chromosomal problems, or this one about unplanned pregnancy.