• Clinical Report Suggests Benefits of Shared Decision-Making
  • September 13, 2017
  • Big decisions about the care and treatment of children with disabilities, including birth defects caused by exposure to toxic chemicals in the workplace, typically fall solely on the child’s parents. The decision-making responsibility can weigh heavily on the minds of mom and dad. But do parents have to shoulder the responsibility of alone?

    The American Academy of Pediatrics (AAP) published a report describing the potential benefits of a decision-making method where parents of children with disabilities work together with the physician to make significant medical decisions for their child. Shared decision-making could potentially allow parents to make better, more informed decisions about the medical care options for their children. The physician would serve as a partner in the decision-making process.

    What is Shared Decision-Making?

    Shared decision-making (“SDM”), according to the authors of the AAP clinical report, is “an interactive process in which patients (families and children, especially more cognitively able children) and physicians simultaneously participate in all phases of the decision-making process and together arrive at a treatment plan to be implemented.” Some key steps of the SDM process are:

    • The parents and the physician acknowledge that a decision needs to be made.
    • The parents and the physician exchange information with each other.
    • The parents and the physician are aware and informed of various medical care options.
    • Each party brings their own relevant knowledge and preferences into the process.
    • The child is given age-appropriate information to make them aware of their condition and potential treatment options.
    • The parents make a decision.

    How Does the Shared Decision-Making Process Work?

    The SDM process begins with discussion and collaboration about routine medical decisions. This allows the parents and physician to build trust and comfort with the process. In time, the physician will gain awareness of the parents’ preferences, and the parents will gain an understanding of the medical options. Once the parties become accustomed to the SDM process, any significant decisions involved with the treatment plan are discussed. The physician serves as a partner to the parents as they ultimately decide on the best option for their child.

    The goal of SDM is to find the perfect middle ground between the autonomy of the parents to make important life decisions for their children, and the desire of the doctor to do what is best for the child’s health. Another benefit of the process, according to the AAP report, is that involving the child in the SDM process can “help their understanding of the condition and treatments, reduce fear, and enhance self-confidence.”