Tools for Making Difficult Decisions

Whether you are newly diagnosed or have an existing chronic disease or condition, there may come a time when you have to make a difficult decision about treatment. 

Usually, what makes the decision so hard is our uncertainty about the benefits and/or potential risks of all the available options—none seems ideal. Or we may lack the information or confidence needed to make a decision preferring instead to trust that our doctor knows what is best. Other times, we may feel pressure from family or from our doctor to agree to an option that just doesn't seem right to us.

Finding information and evaluating options can often be overwhelming and when that happens it's helpful to have a way to think through what is important to us, what risks we are willing to take and how prepared we are to accept the consequences of our decisions. 

The Ottawa Personal Decision Guide takes you through the decision making process with questions that ask you to consider how certain you are about your decision, what you know about the benefits and risks of each option, what more you may need to know, what matters most to you, who else you want to involve, and suggests next steps like where to find information and support.

You can complete the one-page form on line or download a two-page printable version to complete by hand at http://decisionaid.ohri.ca/decguide.html

The forms are also available in Spanish and Japanese.

NexCura has developed what they call "timely, targeted, evidence-based and personally relevant" set of tools for patients with cancer, heart and lung disease that a number of organizations—including the American Cancer Society, the American Heart Association, and the American Lung Association—have incorporated in their websites. You can find the list of tools at http://www.nexcura.com/ToolsAvailable_AboutTools_PatientCare.asp 

All these tools are meant to prepare you for discussions with your healthcare provider so that together you can decide which treatment approach is right for you.

In a recent review of all the clinical studies that have been done to evaluate decision making tools, O'Connor and colleagues found that decision aids increase people's involvement and are more likely to lead to decisions that are informed and based on the individual's personal values—something that no one knows better than you do, not even your doctor.

Reference

O'Connor AM, Bennett CL, Stacey D, et al. Decision aids for people facing health treatment or screening decisions (Review). The Cochrane Collaboration. Published by John Wiley & Sons, Ltd., 2009. Available at http://decisionaid.ohri.ca/docs/develop/Cochrane_Review.pdf