Table 1.
Components of Shared Decision Making Adapted to the ICU Family Conference*
| Dimensions of Shared Decision Making | Example of Physician Behaviors and Questions | |
|---|---|---|
| Providing medical information and eliciting patient values and preferences | Discuss nature of decision | |
| What are the essential clinical issues we are addressing? | ||
| Describe alternatives | ||
| What are the clinically reasonable choices? | ||
| Discuss pros/cons | ||
| What are the pros and cons of the treatment choices? | ||
| Discuss uncertainty | ||
| What is the likelihood of success of treatment and how confident are we in this estimate? | ||
| Assess understanding | ||
| Is the family now an “informed participant,” with a working understanding of the decision? | ||
| Explore patient's values/preferences | ||
| What is known about patient's medical preferences or values? What is important to the patient? | ||
| Exploring family's preferred role in decision making | Discuss family's role | |
| What role should the family play in making the decision? | ||
| Assess desire for other's input | ||
| Is there anyone else the family would like to consult? | ||
| Deliberation and decision making | Explore “context” | |
| How will the decision impact the patient's life? | ||
| If the family is to participate in decision-making, elicit family opinion about best treatment choice | ||
| What does the family think is the most appropriate decision for the patient? | ||
*
Adapted from White and colleagues.4