Deliberation and determination

What does it mean to have a choice in your care?

It’s an interesting question, I think. And may not be as neatly answered as the pat response to an exam: “for example, let the child choose which book to look at while you do the venipuncture!.

If you can’t influence the final yes / no – can you be involved in the decision?

There are many different ways of looking at decision making, and one nice idea is that there is a difference between the “deliberation” (the thinking about the elements involved in a decision) and the “determination” (the making of yes/no).

It might be helpful to reflect on how many discussions have gone in your clinical life; how the inclusion of parents of young people have wanted to understand the clinical thinking that you are undertaking. They may then want to follow out what you suggest – your recommendation – and defer that eventual determination in the decision making process to you. Because they have declined to make the final yes/no – have they participated in the decision or not? Many people will describe this as being involved, a few will not take this view.

What does it mean to have a choice in your care?

– Archi


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