“…Identifying the need for a middle ground, Quill and Brody (1996, p.768) asserted that patient choices "gain meaning, richness and accuracy if they are the result of a process of mutual influence and understanding between physician and patient." Advocacy for shared decision making has been supported by research findings; involving patients in decisions about their own health, for example, has been shown to improve the quality of care and outcomes, including better treatment choices and satisfaction (Powers, Goldstein, Plank, Thomas, & Conkright, 2000) and, can produce useful insights for both professionals and patients to use in disease management problem solving (Zoffmann, Harder, & Kirkevold, 2008). It has also been supported by patient education programs, by policy initiatives such as "patient empowerment" strategies (Department of Health United Kingdom, 2001, by communication aids such as question prompt sheets (Brown, Butow, Boyer, & Tattersall, 1999;Kinnersley et al, 2008), and by lists of competencies for shared decision making for both patients and physicians (Towle & Godolphin, 1999).…”