Epistemic justice is the basis of shared decision making
Epistemic justice is the basis of shared decision making
StatusPost-Print
Alternative title
Authors
Galasiński, Dariusz
Ziółkowska, Justyna
Elwyn, Glyn
Monograph
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Date
2023-03-03
Publisher
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Patient Education and Counseling
Issue
Volume
111
Pages
Pages
1-5
ISSN
0738-3991
ISSN of series
Access date
2024-03-04
Abstract PL
Abstract EN
Background
There is little evidence that share decision-making (SDM) is being successfully implemented, with a significant gap between theory and clinical practice. In this article we look at SDM explicitly acknowledging its social and cultural situatedness and examine it as a set of practices (e.g. actions, such as communicating, referring, or prescribing, and decisions relating to them). We study clinicians’ communicative performance as anchored in the context of professional and institutional practice and within the expected behavioural norms of actors situated in clinical encounters.
Discussion
We propose to see conditions for shared decision-making in terms of epistemic justice, an explicit acknowledgment and acceptance of the legitimacy of healthcare users and their accounts and knowledges. We propose that shared decision-making is primarily a communicative encounter which requires both participants to have equal communicative rights. It is a process that is started by the clinician’s decision and requires the suspension of their inherent interactional advantage.
Conclusion
The epistemic-justice perspective we adopt leads to at least three implications for clinical practices. First, clinical training must go beyond the development of communication skills and focus more on an understanding of healthcare as a set of social practices. Second, we suggest medicine develop a stronger relationship with humanities and the social sciences. Third, we advocate that shared decision-making has issues of justice, equity, and agency at its core.
Abstract other
Keywords PL
Keywords EN
Shared decision-making
Epistemic justice
SDM definition
Communication
Epistemic justice
SDM definition
Communication
Keywords other
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