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

Michele Megregian, Marianne Nieuwenhuijze

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)340-346
Number of pages7
JournalJournal of Midwifery and Women's Health
Volume63
Issue number3
DOIs
StatePublished - May 1 2018

Keywords

  • informed consent
  • informed refusal
  • maternity care
  • midwifery
  • patient refusal
  • patient-centered communication
  • shared decision making

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

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