title: Shared decision making in Brazil: history and current discussion.
abstract: There is no SDM in clinical practice in Brazil. The first steps have been taken towards research and tool development recently. Likewise, our society is starting to get involved with decision making in health care. This paper aims to offer an overview of the Brazilian health system history, its values, and its influence on SDM. The participative social control concept is introduced as a result of the movement against the dictatorship era. In addition, the influence of social changes on the Medical Ethical Code is delineated. SDM state of the art in Brazil is also discussed and the challenges to implement it on clinical practice are described. Regardless the challenges, it is possible to make a positive assessment of SDM in Brazil.
authors.affiliation: Medicine Department, Federal University of São Carlos (UFSCar), Brazil. mirhelen@ufscar.br
authors.forename: Mirhelen Mendes de
authors.initials: MM
authors.lastname: Abreu
authors.forename: Raphael
authors.initials: R
authors.lastname: Battisti
authors.forename: Rachel Samhan
authors.initials: RS
authors.lastname: Martins
authors.forename: Thiago Dias
authors.initials: TD
authors.lastname: Baumgratz
authors.forename: Mirella
authors.initials: M
authors.lastname: Cuziol
mesh_terms: D001938:Brazil; D003256:Community Participation / Q000639:trends*; D003695:Delivery of Health Care / Q000639:trends*; D005544:Forecasting; D006284:Health Plan Implementation / Q000639:trends; D006291:Health Policy / Q000639:trends*; D006801:Humans; D038622:Internationality; D009313:National Health Programs / Q000639:trends; D010358:Patient Participation / Q000639:trends*; D010817:Physician-Patient Relations; D011057:Politics; D012926:Social Control, Formal