2025 Colorado Healthcare Ethics Forum Annual Conference

Shared decision making (SDM) is difficult to implement in mental health practice, but it remains an ethical ideal for motivating therapeutic capacity in patient-clinician relationships; this discrepancy warrants attention from clinical and ethical perspectives. This presentation explores what some clinicians see as obstacles to even attempting SDM with patients with psychiatric disabilities. I identify 4 such obstacles: a patient’s lack of decision-making capacity, a patient’s poor insight, a health care professional’s therapeutic pessimism or personal dislike, and a patient’s or health care professional’s conflicting recovery orientations or goals of care. I argue that each obstacle could be overcome in many cases and that health care professionals, patients, and their caregivers should remain dedicated to attempting SDM in mental health practice.

Objectives:

1. Describe common barriers to shared decision-making in psychiatric care.
2. Analyze how barriers to shared decision-making can be overcome.
3. Discuss ways to understand and enable agency in psychiatric care.

Dr. Guidry-Grimes will be speaking virtually from a conference in Switzerland.