Ethics

Shared decision-making: What to say when patients express regret

Patients do not always understand their diagnoses or treatment options. This means physicians must work with patients to define successful outcomes and provide important information to ensure patients can make appropriate decisions. But in shared decision-making, what exactly should be communicated between physicians and patients?

Ethics in Health Care

Explore the AMA Journal of Ethics for articles, podcasts and polls that focus on ethical issues that affect physicans, physicians-in-training and their patients.

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The May issue of AMA Journal of Ethics®(@JournalofEthics) features numerous perspectives on sharing health decisions and gives you an opportunity to earn CME credit.

Articles include:

  1. When a Patient Regrets Having Undergone a Carefully and Jointly Considered Treatment Plan, How Should Her Physician Respond?” 

    1. Whether a patient’s decisional regret constitutes a failure of shared decision-making can depend on how a decision was made.
  2. Sliding-Scale Shared Decision-Making for Patients With Reduced Capacity.”

    1. Shared decision-making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.
  3. Can Consent to Participate in Clinical Research Involve Shared Decision-Making?” 

    1. Shared decision-making in research informed consent conversations is complex due to diverse and potentially divergent interests of investigators and patient-subjects.
  4. How Should Adolescent Health Decision-Making Authority Be Shared?” 

    1. Shared decision-making is complex with patients who are adolescents, whose relational autonomy is still emerging.

Listen and learn

In the journal’s May podcast, expert Laura Guidry-Grimes, PhD, discusses how health professionals can assess whether and which decisions can be shared with people experiencing mental illness.

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Guidry-Grimes is an assistant professor of medical humanities and bioethics at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, where she also has a secondary appointment in psychiatry. She is also a clinical ethics consultant at UAMS Hospital and Arkansas Children’s.

Listen to or watch previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

Earn CME   

The AMA Journal of Ethics CME modules, “How Should Decision-Sharing Roles Be Considered in Adolescent Gender Surgeries?” and “Overcoming Obstacles to Shared Mental Health Decision-making,” are each designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™.   

Additionally, the CME module, “Ethics Talk: How to Share Decision-making With People Experiencing Mental Illness,” is designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™.

The offerings are part of the AMA Ed Hub™, an online platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards.

Learn more about AMA CME accreditation. 

Submit manuscripts and artwork

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication.

The 2020 John Conley Ethics Essay Contest and the Conley Art of Medicine Contest are now open for submission. Read the essay prompt and see visual media requirements on the AMA Journal of Ethics website.

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AMA Code offers guide on COVID-19 crisis standards of care

Apply to become a theme issue editor to help the journal develop theme issues on interested and neglected topics.

Visit the journal’s COVID-19 Ethics Resource Center for articles, podcasts, and videos relevant to the ethical challenges of the current pandemic.

Upcoming issues of the AMA Journal of Ethics will focus on portraiture in health care as well as humor in health care. Sign up to receive email alerts when new issues are published