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The informed decision-making process

Making a truly informed medical decision involves more than a single decision. It is a step-by-step process in which you take responsibility for making a number of decisions. Your decision to seek help was the first step in that process. The rest of the process is described below.

1. Understand your condition

You can't make an informed decision about something you do not understand. So your first step is to gain knowledge about your disease. To accomplish this, you will need to:

1. Listen carefully to your health care professionals when you are presented with a diagnosis of your condition and a description of your treatment options;
2. Thoroughly read any literature provided by your health care team;
3. Seek out information on your own (many associations provide literature free of charge to the general public); and
4. Ask questions about anything you do not understand.

DECISION #1: Am I willing to take a studious approach to understanding my condition?

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2. Weigh the risks and benefits

Once you have gained adequate information about your condition, you must next weigh the risks and benefits associated with your various treatment options. Keep in mind the impact your condition has on your way of life. Consider the limitations that your symptoms place on your ability to perform those activities that are most important to you.

In some cases, you may discover that the risks involved in having a particular treatment are greater than the benefit you may gain from it. In other cases, the benefit to be gained may outweigh any possible risk. Discuss these issues with your family, and ask your health care team about anything you do not understand.

DECISION #2: Do the potential benefits of this treatment outweigh the possible risks?

3. Develop realistic expectations

What do you want to accomplish by having medical treatment? Do you want to simply gain relief from pain or do you want to return to a particular level of physical activity? After you determine what your goals are, ask your health care professional if your expectations are realistic and what you will have to do to accomplish your goals.

DECISION #3: Am I willing to develop and accept realistic expectations?

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4. Commit to working at recovery

Medical treatment may help to relieve your symptoms, but can't heal your body or return it to a former state of health. Treatment is only the beginning of your recovery process. As your body begins to heal on its own, you must make a physical and a mental commitment to working at regaining your lost abilities. Recognize that it is your effort, your lifestyle choices and the severity of your medical condition that will determine the degree to which you can return to a normal level of activity.

DECISION #4: Am I willing to work at recovery, including making lifestyle changes if necessary?

5. Make a final decision

After you have answered the first four questions, all that remains is for you to make a final decision about which treatment option is best for you. It may be helpful to discuss your options with your family and members of your health care team, but in the end only you can make the final decision. Once you make that decision, trust in it, look to the future and work to achieve the best possible recovery.

DECISION #5: Am I willing to accept responsibility for my own health care decisions?

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A patient-centered approach to medical decision making which empowers patients and involves them in a "partnership" of shared responsibility with their health care professionals.

The traditional approach

Traditionally, medical decisions were made for patients by their health care professionals. The attitude was that doctors and nurses, as experts in the field, were the ones best prepared to choose what was "indicated" for the patient. As a result, patients were left with only a passive role in the decision-making process. It's not difficult to recognize that this is neither a wise nor a desirable way to make any major decision.

Sharing the responsibility

Today, consumers of medical services are seeking to be involved in a meaningful way in the health care decisions. To take that meaningful role and to make a truly informed decision, patients need information about:

1. their medical condition;
2. the risks and benefits of their various treatment options; and
3. their responsibility for actively participating in the treatment and recovery process.

Once patients are empowered with this information, they enter into a "partnership" of shared responsibility with their health care professionals, in which each party agrees to fulfill certain obligations.

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Health care professionals' responsibilities

In a patient-centered approach to medical decision-making, health care professionals are responsible for:

1. establishing a diagnosis;
2. presenting appropriate treatment options, including their risks and benefits;
3. providing patient education;
4. providing the necessary technical skills; and
5. supporting you during your recovery.

Your responsibilities

In this process, you are responsible for:

1. taking a studious approach to learning about your medical condition;
2. weighing the risks and benefits of your various treatment options and accepting their outcomes;
3. developing realistic expectations;
4. making the final decision about which treatment option is best for you;
5. supporting your health care team by faithfully following their instructions; and
6. working at recovering from your condition, including making lifestyle changes if necessary.

Remember, it is your body that will heal itself and your own efforts that will lead to your recovery.

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