Question

Shared decision making is always a positive strategy to take.


True


False

Answer 1

False.

Shared decision making (SDM) is often beneficial, but not always the best strategy. It can be inappropriate or impractical when:
- Immediate action is required (e.g., cardiac arrest, emergency surgery) and there is no time for discussion.
- The patient lacks decision-making capacity and no appropriate surrogate is available.
- The patient explicitly prefers the clinician to make the decision (some patients want a directive recommendation).
- Cultural or language factors make SDM ineffective without appropriate support.
- There is overwhelming uncertainty, or the discussion would cause harm (severe anxiety) and a clear best-interest choice exists.

Recommendation: assess capacity, patient preferences for decision role, urgency, and context; use SDM when feasible and desired, otherwise use clinician-directed decision-making, informed consent, or surrogate/best-interest approaches as appropriate.