This case study briefly describes how the team in Newcastle working on the Health Foundation’s MAGIC programme to implement shared decision making developed a framework to discuss treatment options with haematology patients needing critical care support and their families.
This framework was initially used for discussions around end of life care but is being used increasingly for daily discussions/updates with relatives.
The following headings act as an aide memoire to guide discussions with the person’s relatives:
- Discuss the nature of the decision
- What are the treatment alternatives?
- What are the pros and cons of treatment(s)?
- Uncertainty: what is the likelihood of success?
- What does the family understand about the treatment?
- What is known about the patient’s preferences or values?
- What role should the family play in making the decision?
- Need for input from others: is there anyone else the family would want to be involved?
- Context of the decision: how could it affect the patient’s life?
- What does the family think is the most appropriate decision?