Shared Decision Making in Medicine

During the last decades, a great change has taken place in doctor–patient relationships (Shorter, 1991). Improved diagnostic and therapeutic competence among physicians has led to increasing neglect of history taking and consideration of patients’ interests. The patients’ biology has become more important to physicians than their psyche, and patients often do not have the opportunity to voice their concerns or express their anxieties. This often causes patient dissatisfaction with the consultation, and there is a loss of trust and mutual respect in the doctor–patient relationship. A greater consideration of patients’ concerns and more information exchange between physician and patient could therefore result in a more effective health care system. Decisions have to be made based on the doctor’s knowledge and the patient’s preferences.