Abstract

Shared Decision Making has become paradigmatic in health care. By shared decision-making is meant that both the process and outcome of decisions about treatment options are shared between patient and provider. In mental health care it has very much been associated with the patient’s recovery process. In the over-arching mental health policy framework that the UK government uses, recovery has been defined as: “A deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful and contributing life, even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life’. It is the task of the professional to facilitate this process by empowering the patient: enlarging the scope of his autonomy and self-direction, giving a person as much regime over his own life as possible and sharing the responsibility for decisions about treatment options. However, a dilemma looms up here if and when the patient and the professional have a different opinion on decisions that, according to the professional, may have the risk to land the patient in trouble: exacerbation of symptoms, increasing social exclusion, etc., but which the patient nevertheless wants and which he defends as his good right as an autonomous person.