In 1982, the concept of physician-patient accommodation was renamed shared decision making by the President’s Commission for the Study of Ethical Problems in Medicine. Since then, shared decision making has replaced thousands of years of paternalistic physician-controlled medicine and has emerged as the prevailing model of the doctor-patient relationship in the United States. The President’s Commission’s perspective was closely based on the development of clinical medical ethics (CME) in the early 1970s. CME addresses clinical issues such as truth telling, informed consent, confidentiality, and end-of-life care, and must be practiced by licensed clinicians in their routine, daily encounters with more than 40 million inpatients and about 1.5 billion outpatients in the United States each year. The central goal of CME is to improve the quality of patient care by identifying and contributing to the resolution of ethical problems in the practice of clinical medicine; this goal is frequently achieved by shared decision making.
Shared decision-making in the People’s Republic of China: current status and future directions