Meaningful shared decision-making: complex process demanding cognitive and emotional skills

Background Shared decision-making (SDM) takes place when clinicians help patient identify best course of action in the context of their preferences. Methods The aim of this paper is a narrative review of the literature with special focus on the humanistic dimensions of SDM. Results We show that SDM is largely underused in practice, because of many barriers such as time constraints and poor skills. Conclusions We suggest that listening and empathy are key challenges in communicating uncertainty, which require emotional intelligence and trust building skills. To promote implementation, we propose the development of tools, simulation-based training and the design of improved measures for SDM quality. While essential for patients, we believe that SDM may restore meaning in healthcare.