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Ethical, Legal, and Regulatory Considerations in Health Care: Shared Decision-Making

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Patient-centered care is a frequently mentioned concept in modern health care. Its main idea is to consider patients’ needs and achieve desired health outcomes by inviting patient input into making specific decisions. This type of care promotes improved self-management, patient satisfaction, and adherence to medication (Elwyn et al., 2014). Decision-making is a central issue in patient-centered care, and it is important to develop clear approaches and well-defined steps.

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Shared decision-making is one possible model to follow, in which patients play a crucial role in medical decisions and have a chance to affect their health. The main problem is that not all nurses are currently aware of the principles of this model and may fail to use it properly. This project seeks to discuss the problem of a lack of shared decision-making in patient-centered care and the necessity for nurses to learn its application to achieve the best health outcomes.

The intervention of shared decision-making in healthcare settings includes several stages. First, it is necessary to determine whether patients have sufficient trustworthy information for their future participation in medical discussions. Nurses must understand their role as primary data providers and help patients express their personal values and interest in their conditions and preferred treatment plans. Shared decision-making must empower patients to be ready for self-management and collaboration (Smith, 2016). The education of nurses on how to guide patients and remain unbiased regarding care details cannot be ignored.

Another important aspect involved in promoting the chosen model of communication between patients and medical staff is the establishment of respectful relationships. Some medical professionals may hold the opinion that patients lack sufficient knowledge and experience to make their own decisions and thus influence their treatment. Partnership with doctors, nurses, and other medical workers can provide the opportunity for patients and their families to improve their knowledge and prepare for direct involvement. Therefore, this proposal to expand patient knowledge and establish trustful relationships promises an effective solution for the problem of neglecting or ignoring the practice of shared decision-making.

To ensure that the proposal promoting shared decision-making in patient-centered care settings works well, it is important to identify all associated ethical, legal, and regulatory considerations. From an ethical point of view, shared decision-making can present certain challenges because, in some situations, sufficient time may not be available to discuss available knowledge or to decide on a diagnosis.

The priorities can be difficult to understand, in terms of balancing time spent educating patients and explaining all medical terms and conditions against the need to take immediate measures to save patients’ lives. In addition, it is necessary to organize decision-making in accordance with specific ethical principles, including autonomy, justice, and beneficence (Elwyn et al., 2014). All these aspects must be thoroughly explored as they relate to the hospital’s standards and human rights.

Legal aspects are also involved in the process of shared decision-making in patient-centered care. The Patient Protection and Affordable Care Act aims to improve the aspects of healthcare delivery and health outcomes (Smith, 2016). The National Quality Strategy, developed in 2011 to address these aspects and promote collaborative input (Smith, 2016), seeks to ensure that the chosen model of communication between nurses and patients meets such criteria as the effective development of decision aid, positive outcomes of decision-making, and the consideration of federal and state regulations.

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In addition, in the U.S. healthcare system, a list of regulations determines the quality of care and guides medical workers. These guidelines include Medicaid and Medicare, which cover uninsured pregnant women or unemployed individuals, and the Health Insurance Portability and Accountability Act legislating that all American workers are allowed to carry health insurance. Finally, the role of local guidelines and standards in hospitals and other healthcare settings cannot be ignored. All medical workers are required to follow certain principles and duties. Shared decision-making should not lead to any violation of rules.

The choice of such a problem as the lack of shared decision-making practices in patient-centered care settings can be explained in several ways. From the nurses’ standpoint, this model may provide a helpful tool for gathering adequate information about patients and their past diseases as well as specific genetic or environmental issues. On the part of patients, this method of collaboration provides an additional, credible source of information and education.

As soon as nurses explain the value of self-management and quality of life to their patients, the latter can achieve positive health outcomes in a short period of time. When patients are interested in helping to develop their treatment plans and discussing their health problems with experts, they can discover new aspects of care and contribute to their recovery. In fact, shared decision-making is characterized by a number of benefits, including patient satisfaction, decreased anxiety, and the improved use of healthcare resources.


In general, recent improvements in health care and the possibility of developing professional relationships between patients and healthcare workers are provoking an urgent need for such effective care models as shared decision-making. Many nurses continue to face considerable problems because of a lack of knowledge about this method or poor experience in the field. This project proposal presents the first step in improving the situation and providing all stakeholders with an opportunity to study the basics of shared decision-making.


Elwyn, G., Dehlendorf, C., Epstein, R. M., Marrin, K., White, J., & Frosch, D. L. (2014). Shared decision making and motivational interviewing: Achieving patient-centered care across the spectrum of health care problems. The Annals of Family Medicine, 12(3), 270-275. Web.

Smith, M. A. (2016). The role of shared decision making in patient-centered care and orthopaedics. Orthopaedic Nursing, 35(3), 144-149. Web.

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