The shared decision-making model and practical discourse to foster the appreciation of patients’ value preferences in Polish healthcare: Discussing potentials and challenges

Excerpt

The aim of the paper is to consider the potential and challenges regarding the implementation of the shared decision-making approach in the Polish health care system, also taking into account the moral and communicative-discursive advantages of such a change. The paper consists of several sections, in which the author: defines the objectives and method of the paper (Sections 1, 2), presents the theoretical background of changes in health care (Section 3), and outlines the characteristics of Polish health care and the legal-institutional framework in Poland after the democratic turn in 1989 in terms of the ongoing communicative crisis in the relations between patients and health providers (Section 4). Next, the author distinguishes the ethical essentials of shared decision making, also presenting its affinities with J. Habermas’ communication and discourse ethics, as an approach which can be applied in the clinical practice of medicine (Section 5), including the shared responsibility principle (Section 6). The next step was to name reasons for which health and medical values, SDM and practical discourse ethics can be linked together (Section 7). Then the author considers how the SDM model could be implemented through sampling cases from other countries (Section 8). Subsequently, she describes structural and normative potentials to adapt SDM and practical discourse ethics for Polish public health care (Section 9). A discussion follows.