Clinical reasoning as midwifery: A Socratic model for shared decision making in person‐centred care

Abstract

Shared decision making has become the standard of care, yet there remains no consensus about how it should be conducted. Most accounts are concerned with threats to patient autonomy, and they address the dangers of a power imbalance by foregrounding the patient as a person whose complex preferences it is the practitioner's task to support.Other corrective models fear that this level of mutuality risks abdicating the practitioner's responsibilities as an expert, and they address that concern by recovering a nuanced but genuinely directive clinical role. Cribb and Entwistle helpfully categorize models of shared decision making as 'narrower' and 'broader' and praise the latter's 'open-ended and fully dialogical ways of relating'. However, they stop short of providing a philosophical account of how that dialogue works. In this paper, a nurse-midwife and a philosopher collaborate to argue that the Socratic model of dialogue offers a solution to the practitioner-patient dilemma. In the Theaetetus, Socrates compares dialogical reasoning to 'midwifery with all

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“…The reasons for this might be that nurses and midwives approach patient data holistically, spend more time with patients and monitor and further assess their condition, engage in problem solving at the bedside by carrying out countless orders regarding care, ensuring its quality, and, above all, anticipate the risk of emergencies. Furthermore, nurses' and midwives' practice is focused on providing patient-centered care [51,52].…”

Critical Thinking in the Nursing Profession: Analysis with a Socratic Method and Nurse Theorist Philosophy

“…It can lead to the development of a higher-order level of cognitive skills among students when they use their mental ability to precisely responding the questioning [14] . In recent times, it is equally important that nurses have a profound understanding of the Socratic Method as nurse leaders inculcate it in the nursing curriculum [15] . The Socratic Method enables sensible decision-making, accomplished by reasoning that promotes incredible thinking [15] .…”

“…In recent times, it is equally important that nurses have a profound understanding of the Socratic Method as nurse leaders inculcate it in the nursing curriculum [15] . The Socratic Method enables sensible decision-making, accomplished by reasoning that promotes incredible thinking [15] . Both teachers and students interested in probing thinking in-depth must formulate the Socratic Method that may probe critical thinking profoundly.…”