Shared decision-making in the realm of uncertainty: The example of coronary artery disease through an EBM and complexity science lens

Experiential Fallibilism and Decision-Making Process: A Perspective from a Patient with Chronic Kidney Disease

Patient choice in healthcare follows a process in which references to evidence and experience are intertwined. From the perspective of a patient with chronic kidney disease, I propose experiential fallibilism as the use of uncertain evidence and experience, along with knowledge gained in new contexts, situations, and experiences, to attain truth and promote shared decision-making. Thus, because of their uncertain nature, both the patient's experience and the doctor's focus on evidence should be integrated into a decision-making process through a co-learning perspective so that they can mutually enrich each other and prevent inappropriate actions and decisions in other clinical contexts. The risks perceived by both the patient and the doctor should be valued equally to encourage an honest discussion of the benefits and drawbacks of the proposed treatments after considering the patient's social, economic, and medical situation. Further, experience measurement tools, both quantitative and qualitative, should be used or developed to test their transferability and effectiveness in contexts involving healthcare decisions between doctors and patients.