| Description |
Physicians have traditionally held a dominant position in healthcare. During recent decades, the historically paternalistic system of medical service provision has been replaced with interdisciplinary teams that provide care to patients. The resulting changes to the social organization of healthcare delivery raise questions about the role that power, knowledge, and autonomy play during medical decision making encounters. Shared Decision Making (SDM) is a concept describing a collaborative process between patients and clinical care providers where the patient's individual experiences, needs, and values ideally are incorporated into the decision making process alongside the clinician's evidence-based recommendations. SDM seeks to reconcile the patient's individual levels of power and autonomy with those of the provider. The notion of SDM is of growing sociological interest but is understudied in clinical team settings, resulting in a gap of knowledge around the factors that affect SDM. This dissertation project contributes to the current knowledge by unpacking decision making processes within and between healthcare teams. The focus is specifically on palliative care, a medical arena in which SDM and team based care delivery are integral components. A central goal is to elucidate the ways in which palliative care team members use and make sense of SDM within the context of their work with other clinical providers in a healthcare organization. The findings reveal insights into the ways in which teams make decisions about patients, and the ways in which patients are, or are not, involved in the decision making processes. |
