Box 3.

Getting the balance right.

Faced with the following situation, which response would work best?
Clinician:	So, as we have discussed, there are a couple of options for you to consider…
Patient:	Oh I don’t know doctor, what do you think I should do?
Response 1:	I’m glad you asked. I think you should…
Response 2:	Oh, I couldn’t possibly say. You will just have to work it out for yourself…
Response 3:	Well, I’ve seen a number of people in this position make different decisions depending on what’s right for them. What I’d like is to try and help you make the decision you feel is right you. Tell me what ideas you’ve had or what thoughts you have at the moment …
The patient’s question may represent a genuine preference to be guided, but may also reflect passivity or a hesitation around their role or time to think it through. Jumping in and assuming the former (response 1) may limit the conversation and the person’s involvement.
At the other extreme, this should not be confused with abandoning people to fend for themselves entirely (response 2). Exploring a little further, while normalising their uncertainty, may provide a better opportunity to work together for an outcome that is right for them (response 3).