The BMJ Today: Barriers to shared decision making

tinukeA research study published online in the journal Cancer has suggested that the rate of invasive cervical cancer in the United States is much higher than had been previously thought. The study, conducted by Anne F Rositch, of the University of Maryland School of Medicine in Baltimore, and Patti Gravitt, of the Johns Hopkins Bloomberg School of Public Health, also in Baltimore, concludes that the incidence of cervical cancer among all women with an intact cervix did not decline after menopause, and actually increased—particularly among African American women. With this in mind, there are of course concerns about the cessation of routine cervical cancer screening, which guidelines currently advise should be offered until age 65.

Anton E Joseph recounts his experiences of working in Sri Lanka during the 1960s, which included the task of verifying deaths at executions by hanging and, ironically, performing autopsies on the bodies after they were hanged. In providing his own personal account of capital punishment, Joseph questions why we are spending time trying to find ways to make executions humane, and instead argues that it should be abolished in its entirety.

There is also a thought provoking analysis paper on the shared decision making process, which evaluates the different barriers that need to be addressed in order to improve the current situation. The paper theorises that “achieving shared decision making in routine practice will require interventions targeted at both clinicians and patients.” From my own experience in trying to have input into my medical care, I tend to agree with them

Tinuke Bernard is assistant editor, web production, The BMJ.