The Emerging Importance and Relevance of Shared Decision Making to Clinical Practice

Since the President’s Commission first coined theterm ‘‘shared decision making’ ’ over 30 years ago, it has been seen as an elusive ethical ideal in clinical practice.1 Clinicians have long misunder-stood the ethical precept, confusing it with notions such as ‘‘Let the patient decide’ ’ and ‘‘Make sure you give the patient all the information possible’ ’ and bemoaning ‘‘How can I do this in a busy practice?’’ The emergence in the last 2 decades of empirical research examining patient-clinician communica-tion in general and shared decision making in parti-cular has fueled increasing interest in moving shared decision making from ethical ideal to actual practice. Many of these efforts have found voice in the growing movement to develop and deploy deci-sion aids, products that help patients become more