Except in an emergency, you cannot be given a treatment or test without your “informed consent.” You must be informed of the risks and agree to the treatment. In a partnership, however, informed consent may not be enough. The real goal is shared decision-making, where you actively participate in every medical decision.
Why should you help make decisions with your doctor? Aren’t you paying him or her to know what to do? Well, the choices aren’t always black and white. With many health problems, there is more than one option. Consider these examples:
- You have moderately high blood pressure (160/95). Your doctor says that exercise and diet might bring it down, but most people don’t succeed that way. Your doctor recommends that you start on medication to control it. You would rather try exercise and lose weight than take pills for the rest of your life. The best decision depends on your values.
- Your three-year-old has a headache and a fever. The doctor says it’s probably nothing to worry about. Then you mention your hunch that it might be meningitis. Some testing may be appropriate.
- You have been suffering from carpal tunnel syndrome for several months. Your doctor is now recommending a wrist splint and a steroid injection. You would prefer
trying just the splint with aspirin first. If that doesn’t work, you will consider other medications. Your doctor agrees that is a good plan.
In each case, the treatment you choose will have an effect on your life. Therefore, the best medicine for you combines your doctor’s medical expertise with your personal values.
Eight Ways to Share in Medical Decisions
1. Let your doctor know what you want. Tell your doctor that you want to help make decisions about what to do for your health problems.
2. Do your own research.
Sometimes you need to learn things on your own before you can fully understand what your doctor is saying. See “Do Your Own Research” on page 15 for some ways to get the information you need.
3. Ask “‘why?” Always ask “why?” before agreeing to any medical test, medication, or treatment. Asking why may help you discover another option that better meets your needs.
4. Ask about alternatives. Learn enough to understand the options your doctor thinks are feasible.
5. Consider watchful waiting. Ask your doctor if it would be risky or costly to wait a while (day, week, month) before treatment.
6. State your preferences. Tell your doctor if you prefer one option over another based on your personal desires and values.
7. Compare expectations. Tell your doctor what you are expecting from the treatment and ask if that is real-istic. If appropriate, discuss side effects, pain, recovery time, long¬term limitations, etc.
8. Accept responsibility. When you make shared decisions with your doctor, both of you must accept the responsibility for the outcomes.