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When is a shared decision not (quite) a shared decision? negotiating preferences in a general practice encounter

Gwyn, Richard and Elwyn, Glyn 1999. When is a shared decision not (quite) a shared decision? negotiating preferences in a general practice encounter. Social Science & Medicine 49 (4) , pp. 437-447. 10.1016/S0277-9536(99)00067-2

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Abstract

We consider whether there are situations in which `shared decision making' in primary care is inherently problematic, such as in the demand for antibiotics to treat viral disorders. In such an instance there might be a lack of the equipoise necessary for a decision-making context in which apparent choices are genuine options. Using the techniques of discourse analysis on the transcript of a consultation with the parents of an infant with tonsillitis, we illustrate how a general practitioner's (GP's) efforts to reach a `shared decision' come unstuck through a combination of the embedded power imbalance and the conflict between the GP's own prescription preferences and those of the parent.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Shared decision-making; Primary care; Treatment preferences.
Publisher: Elsevier
ISSN: 0277-9536
Last Modified: 04 Jun 2017 06:50
URI: http://orca.cf.ac.uk/id/eprint/65196

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