Collaborative decision making in liquid times

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Clinical Reasoning in the health professions, 2019, 4th, pp. 159 - 167 (8)
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Health care practice is rapidly changing with advances in technology in a globalised world. The way we practise, communicate and relate to each other is relentlessly changing and with it the way we make decisions. Decision making in health care practice is an important clinical reasoning process and issue. It has impact on efficiency and consequences for effectiveness. In a simple (science-driven) world health care practitioners would make expert decisions based on scientific empirico-analytical evidence which promises the best health outcomes. Patients would concur with the expert decision and carry out the behaviours required. This portrays decision making from a biomedical model perspective where roles of patients and health care practitioners are clearly defined. Decision making affects not only patients, their families and carers but also health care teams and services. Furthermore, decision making occurs within socio-political contexts. Decisions about post-surgery treatment in a first world country with free health care insurance looks differently to developing countries. The decision making process needs to include economic, educational, cultural, ethical and material considerations. Whose interests are being considered? Whose interests prevail? What role do hospital budgets, bed occupancy, views about good health and a quality life play? What else should be included that enables productive and effective decisions? In this chapter, we focus on collaborative decision making and explore the new conditions of decision making processes in liquid times (or times of rapid change, where the only real constant is change itself), discuss conceptual perspectives and principles of collaborative decision making and report on a critical practice perspective on collaborative decision making.
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