Choosing to Decline: Finding Common Ground through the Perspective of Shared Decision Making

Journal of Midwifery & Women's Health
Michele Megregian, Marianne J Nieuwenhuijze

Abstract

Respectful communication is a key component of any clinical relationship. Shared decision making is the process of collaboration that occurs between a health care provider and patient in order to make health care decisions based upon the best available evidence and the individual's preferences. A midwife and woman (and her support persons) engage together to make health care decisions, using respectful communication that is based upon the best available evidence and the woman's preferences, values, and goals. Supporting a woman's autonomy, however, can be particularly challenging in maternity care when recommended treatments or interventions are declined. In the past, the real or perceived increased risk to a woman's health or that of her fetus as a result of that choice has occasionally resulted in coercion. Through the process of shared decision making, the woman's autonomy may be supported, including the choice to decline interventions. The case presented here demonstrates how a shared decision-making framework can support the health care provider-patient relationship in the context of informed refusal.

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Citations

May 8, 2018·Journal of Midwifery & Women's Health·Tekoa L KingAngela M Wilson-Liverman
Jun 18, 2019·Journal of Midwifery & Women's Health·Melicia Escobar, Stacey Shearin
Jan 17, 2021·Nursing for Women's Health·Sarah A SandersMartha A Terry

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