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Shared Decision Making in Psychiatry: Dissolving the Responsibility Problem

El Alti, Leila



Person centered care (PCC) invites ideas of shared responsibility as a direct result of its shared decision making (SDM) process. The intersection of PCC and psychiatric contexts brings about what I refer to as the responsibility problem, which seemingly arises when SDM is applied in psychiatric settings due to (1) patients’ potentially diminished capacities for responsibility, (2) tension prompted by professional reasons for and against sharing responsibility with patients, as well as (3) the responsibility/blame dilemma. This paper aims to do away with the responsibility problem through arguing for a functional approach to mental illness, a blameless responsibility ascription to the person with mental illness, as well as a nuanced understanding of SDM as part of an emancipation-oriented PCC model.


El Alti, L. (in press). Shared Decision Making in Psychiatry: Dissolving the Responsibility Problem. Health Care Analysis,

Journal Article Type Article
Acceptance Date Nov 17, 2022
Online Publication Date Dec 3, 2022
Deposit Date Jan 10, 2023
Publicly Available Date Jan 10, 2023
Journal Health Care Analysis
Print ISSN 1065-3058
Electronic ISSN 1573-3394
Publisher Springer
Peer Reviewed Peer Reviewed
Keywords healthcare ethics, mental illness, person centered care, patient responsibility, patient emancipation


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