FROM INFORMED CONSENT TO SHARED DECISION P. Ragni, S. Baruzzo, - - PowerPoint PPT Presentation

FROM INFORMED CONSENT TO SHARED DECISION

• P. Ragni, S. Baruzzo,
• A. Nini, R. Gombia,
• F. Gazzotti,
• M. Bondavalli,
• A. Chiarenza, D. Riccò

Informed consent (IC)

IC is often understood as:

• a formality for informing the patient about a proposed and

risky diagnostic or therapeutic procedure

• a safeguard offering the provider legal protection (defensive

medicine)

• a mini- Encyclopaedia Britannica about medical

complications

But…look at our Education programme on IC, please

• 1. The autonomy

Kant Socrates

• 2. Debate or Dialogue?

Funtowicz

• 3. Complexity and uncertainty

(Post-normal science)

M B Abram

• 5. Sharing decision making

Boniolo

• 4. Decision (The art of deliberating)

Awareness indicates not only the acquisition of technical information, but the activation of active information processing by the patient

(Langer, 1989)

Medical decisions can concern various aspects, from survival to the risk of permanent damage and quality of life However in the choosing process, objective and subjective wellbeing of the patient is involved, which also affects the psychic and social dimension. Therefore, the decisions must also consider the systems of values, beliefs and principles of each person”.

(Pravettoni and Vago, 2011)

Doctor’s competences (expertise)

Patient’s competences (expertise)

Diagnosis Disease’s etiology Prognosis Treatment options Outcome probability Illness/Disease Experience Social environment Risk Propensity Values Personal Preferences

The citizens, our precious consultants …

…and our colleagues surgeons during education on IC