Abstract

ESTRADA-BELLMANN, Ingrid  and  MELENDEZ-FLORES, Jesús D.. Ethical implications of shared decision-making in Parkinson’s disease treatment. Rev. mex. neurocienc. [online]. 2020, vol.21, n.6, pp.235-239.  Epub July 30, 2021. ISSN 2604-6180.  https://doi.org/10.24875/rmn.20000022.

Shared decision-making (SDM) involves an active participation of the patient in deciding treatment choice, based on his/her preferences, beliefs, and values. In the context of Parkinson’s disease (PD), physicians encounter limitations in applying this model related to cognitive decline and other disease-related complications. Discussing the ethics of this approach on the context of these limitations the PD patient suffers is thus of great importance. This review intends to analyze ethical challenges of SDM in PD related to decision-making capacity, surrogates’ role in patient’s identity, and patients’ and physicians’ preferences. Although skepticism could arise when dealing with surrogates’ decisions, a key for flourishing the patient’s autonomy is acknowledging its relational context, as relatives’ beliefs and values are imprinted in the patient’s identity. To do so, empathy should be encouraged in physicians, recognizing the different value attribution that patients and their relatives have in the decision process.

Keywords : Cognition; Parkinson disease; Shared decision-making; Surrogate decision maker.