Shared Decision-Making
摘要
Humanism is a central part of medical education. Without humanism there is no Medicine; we can have doctors, diagnosis, surgeries, or other treatments, but not Medicine. In order to have real Medicine, we need doctors embodied with the core principles of medical ethics, doctors committed to their patients, and the doctors to whom the patient–physician relationship is the real center of their practice and concern. There are several problems that affect Medicine nowadays, namely the acceleration of time or, in other words, the lack of time. The acceleration of time has profoundly changed the patient–physician relationship, and the next generation of doctors will need to repair the wounds created by this societal change. Surgery has also changed a lot over the last decades, as well as surgeons. Surgery, once viewed as a sentence of death, is now seen as a sentence of cure. There is a huge misconception about the role of surgery in the overall treatment of patients, and those myths must be deconstructed. The whole health system needs to adapt to this perspective, instead of surfing the wave and using the patients and their ignorance to profit more and more. Those myths must be deconstructed starting from the real base of the pyramid, informed consent. A truthful shared decision-making between doctors and patients requires: addressing patients’ lack of knowledge, promoting health literacy, speaking patients’ language instead of speaking very complex technical jargon in order to lead the patients to take decisions that are ours and not theirs. I have written this chapter from the perspective of a Portuguese Surgeon who has already experienced what surgery is like in other European countries, being therefore able to raise issues that are culturally embedded and other issues that are transversal to the European Landscape.