IUGA Meeting 2023- Decision Making for Treatment: Whose Shoes?

Decision Making for Treatment: Whose Shoes?

Effective and inclusive decision-making  by Toni Abulafi, covers the importance of shared decision making which is vital to patient-centered care. It enhances patient autonomy and shared decision-making. More time spent communicating and explaining with the patient and caregiver could resolve all the barriers that lead to dissatisfaction which many studies have supported. In other words, the key to better health and well-being is engaging and stimulating the patient to collaborate with their clinician to plan their management plan. However, clinicians also need to take into account individual patient, their values, and circumstances, and help to come up with a decision that is best for them but also based on their preferences.

How to provide the best information

Monica de Haide talks about providing the best way possible to ensure that all patients are given consistent and adequate information for consent. The use of patient information leaflet, patient decision aid, or patient-specific consent allows standardization during shared decision-making. All these tools allow better understanding as it is designed to use simple language and allow patients to discuss better with their family, friends, and GPs. It also allows time for them to digest and understand their conditions better. Also, during the discussion, clinicians need to clarify to patients the risk of surgery and their willingness to accept it and quote the rate of complication/ success following the standards/ hospital numbers. Informed consent is the paradigm to protect the legal right of the patients and allow them to make choices based on their values, and it has to be the very basis of the ethical practice of medicine.

Involving patients in information and research by Frederike Siemens

Patient advocacy and involvement ensure the patient's perspective in research design. Arguments include patient rights, efficiency (consequential), and practical points. Although a systematic review of the framework for supporting patient and public involvement in research describes 65 different frameworks, nobody follows a standard way. Dr. Frederike Siemens gave an example of the bio-design process which he is very much involved, and elaborated further on the process. The first step is identification; the process requires active patient and community involvement, followed by inventing the process. This course includes brainstorming on a patient’s need using an FDA benefit- Risk framework to look at the evidence, available treatment, and benefit-risk of a new treatment to analyze the risk involved. That further led to the next step of implementation by developing a prototype- testing, efficacy, and safety and looking at intellectual property strategy and stakeholders. He concludes that patients' perspectives are paramount; engaging patients is a great concept and a valuable way to test the assumption; however, it is challenging in real practice. As scientists and clinicians, we can’t just stop at proofing assumption but testing it- that’s where the value comes from!