Thursday, 24 September 2020

Supported Decision Making, NOT Shared

‘Shared Decision Making’ is taking up a lot of space in system conversations as the next ‘hot new thing’, but there’s a lot to think about whenever taking on a new ‘next thing’. For example:

  • Is it really changing things or just repackaging the same old stuff?
  • If it really is making a change, is it definitely headed in the right direction?
  • How consistent is it with other efforts a group or system is currently working on?
  • If it’s not consistent, what else needs to change so that one isn’t constantly stuck in a circle of defeating all movement by trying to do opposing things all at basically the same time?

This article will not address all these issues, but it will start with one:

Should we be working on ‘Shared’ Decision Making… or ‘Supported’?

Shared is not the same as supported. Specifically, unless two people are truly making a decision that is close to equally impactful for both of them (e.g., when a couple decides to move to another state or similar), then a decision is not shared. To suggest that it is shared, when what we’re really talking about is a doctor or other treatment provider being a part of making a decision that they get to walk away from when they return to the rest of their life, will ultimately feel dishonest, patronizing, and possibly even coercive to a lot of people.

Instead, we ask that people adopt the language of ‘supported decision making’ (already in use in many legal circles) to much more clearly signify that decisions often belong to one person, but that that person may sometimes benefit from a supportive process that helps them learn about and weigh options, concerns and the realities of various situations.

This may seem like a trivial matter, but how we talk about and name things can impact our ability to work with them and with each other in dramatic ways. Once we agree that we’re talking about ‘Supported Decision Making’ and not ‘Shared’ that leaves room for many other conversations!

Stay tuned for more in coming months!



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