Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness

The Article in Brief

Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness

Ronald M. Epstein , and colleagues

Background Individuals often rely on others to help them make difficult medical decisions, especially when dealing with a serious illness. This article explores why, when, and how people involve trusted others in sharing information, deliberating, and decision making.

What This Study Found The authors introduce the concept of "shared mind:" ways in which new ideas and perspectives can emerge when 2 or more people share thoughts, feelings, perceptions, meanings, and intentions. They explore how shared mind manifests in relationships and organizations, how it might be promoted through communication, and its implications for decision making and patient autonomy. The article also looks at a continuum of patient-centered approaches to patient-clinician interactions and proposes that autonomy and decision making consider not only the individual perspectives of patients, their families, and members of the health care team, but also the perspectives that emerge from the interactions between them.

Implications

• Shared mind, like caring, may be difficult to measure, but that should not diminish its importance
• By being aware of shared mind, clinicians can note ways in which they and others can make helpful contributions to decision-making processes and enhance patient autonomy.