Which factors should be part of standard required reconsideration discussions?

Using alternative anesthesia techniques requires collaborative decision making that expresses a patient’s best interest.

Current policy requires separate informed consent for some Public Health Service increased-risk donors, and this can make shared decision making harder.

Whether a patient’s decisional regret constitutes a failure of shared decision making can depend on how a decision was made.

Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.

Shared decision making in research informed consent conversations is complex due to diverse and potentially divergent interests of investigators and patient-subjects.

During immediate and long-term recovery periods, decisions must account for patients’ personal goals and possible clinical outcomes and should clarify what recovery means.

Ideally, patients and clinicians should have sufficient time to engage in SDM. In reality, time is often insufficient.

Reliance on disclosure rather than understanding has prompted shared decision making and represents an important cultural change in clinical practice.

Shared decision making is practically difficult to implement in mental health practice but remains an ethical ideal for motivating therapeutic capacity.