Shared decision making in mental health: a novel approach

Med Etica. 2021 Oct;32(4):1111-1133. doi: 10.36105/mye.2021v32n4.05.

Abstract

The health system tends to underestimate the ability to make decisions of people with mental illnesses, characterizing them as vulnerable and adopting a stigmatizing attitude towards this vulnerability. Therefore, their autonomy, in the classical sense of the term, is reduced or nullified. Another way to respond to vulnerability is by promoting autonomy, conceiving it as contextual and autonomy in a relational way. This could be beneficial for people with mental suffering because it allows analyzing what conditions could improve or harm the exercise of autonomy and consider the help of others in decision-making. The shared decision-making process is a form of collaboration between professionals, patients and/or family members, in which the available evidence is shared with the patient and contextualized when faced with the task of making decisions in the medical environment.

Keywords: Mental health; health vulnerability; joint decision making; relational autonomy; social stigma.