Shared decision-making and argumentation

Abstract Shared decision-making has become the ideal for medical decision-making. Given the pivotal role of argumentation within this process, shared decision-making has increasingly been examined through the lens of argumentation theory, particularly pragma-dialectics. This perspective paper outlines the pragma-dialectical contributions to the analysis of shared decision-making and explores the potential of this theory for addressing current and future challenges in medical decision-making. It aims to show that normative argumentation approaches, particularly the pragma-dialectical approach, are crucial for understanding and possibly improving shared decision-making. First, the paper discusses the alignment between shared decision-making and the ideal of a critical discussion, barriers to shared decision-making as violations of discussion rules and higher-order conditions, and the application of the pragma-dialectical approach to complex decision-making scenarios involving patient companions. Second, it considers how the pragma-dialectical approach may be used to confront the emerging issues of medical misinformation and artificial intelligence in medical decision-making.