What Healthcare Can Do Before a Patient 'Decides'

—The power to stand by someone during a time when they 'cannot choose'

'It might be time to start considering hemodialysis.'

'It might be time to start considering hemodialysis.'

For a 72-year-old patient, the world stopped at those words.
He had been visiting the general hospital for a long time for hypertension. An unexpected declaration.
'If you do not undergo dialysis, there is a high possibility that your life will be at risk.'
Even after being told that, his mind remained a complete blank.

—Why did it come to this?
—What criteria should I use to think about this?
—Do I really have to decide this myself?

After leaving the examination room, he stood still.
'It might be easier if the doctor just decided for me.'
However, deep in his heart, he also thought:
'Is that really okay?'

Support that recognizes the patient who 'cannot choose'

We often say we 'respect self-determination.'
However, in reality, there are patients who have lost the 'power to choose.'
Sudden information, anxiety, and confusion. They cannot keep up with processing their emotions.

At such times, what is needed is not to urge them to 'please choose.'
It is to understand that they are 'in a state where they cannot choose' and to stand by them.
And such words can support that person's heart.

'You must have been surprised by this sudden news.'
'If you'd like, let's think about it together. Why don't we start by talking about your life moving forward?'

The beginning of that dialogue is the first step in decision-making support.

From 'information' to 'conviction'—the power created by dialogue

Whether or not to undergo dialysis. That is not merely a choice of medical procedure, but
a time to think about how you want to live from now on.

That is precisely why what is required of healthcare professionals is not to show the 'correct answer,' but

the ability to search together for a 'choice you can be convinced of'.

'What kind of life would make you feel like yourself?'
'With whom, and what kind of time do you want to spend?'

Those questions illuminate the patient's values,
and they quietly regain their 'power to choose.'

What it means to support 'a patient choosing a treatment they are convinced of'

Before a patient 'decides,' there are things healthcare can do.
That is not just providing information, but
building a relationship of dialogue and supporting the 'power to be convinced.'

Refining those skills and that attitude is the
Shared Decision Making skillthat we provide.

Won't you join us in spreading healthcare that stands by people during times when they 'cannot choose' and leads them to a choice they can be 'convinced of'?