Decision Making in the Context of Health and Illness

[Page 293]Shared decision making has evolved from a traditionally paternalistic model of decision making to an approach that has been developed on a platform based on a patient-centered approach. After the development of a professional approach to medical practice in the 18th century, decision making has, to a large extent, been dominated by a paternalistic approach by which clinicians assume authority and decision-making power, oftentimes without consulting individuals about their personal preferences. Since the 1980s, individuals’ right to be informed and to participate in medical care decisions has been increasingly advocated. It has also been postulated that clinical decisions (treatments, screening or diagnostic tests) should be justified by available clinical and scientific evidence and not by a clinician's assumed authority or knowledge—this development has become ...