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about their care, even when faced with a serious diagnosis. Shared decision making is essential to ensure that individuals are supported to make decisions that are right for them. Using a collaborative process, the clinician should highlight the treatment options, evidence, risks, and benefits and, together with the person, seek to understand how these fit with that person's circumstances, goals, values, and beliefs. 56

Demographers have often lamented their field's reputation as one of “all methods and no theory.” Pushed by advances in computer technology and pulled by the appeal of being the “hardest,” most scientistic of the social sciences, the field has grown ever more sophisticated in mathematical technique. At the same time, theory has languished, becoming increasingly narrow and divorced from the realities of a rapidly changing post-Cold War world (McNicoll 1992). Leading members of the field routinely bemoan this state of affairs, though proposals for remaking the discipline are rarely offered (Preston 1993; Keyfitz 1993).

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