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The state of shared decision making in Malaysia

Lee YK, Ng CJ

Z Evid Fortbild Qual Gesundhwes, 2017 Jun;123-124:66-68.
PMID: 28527637 DOI: 10.1016/j.zefq.2017.05.019

Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making.
Fulltext Shared decision-making in Malaysia: Legislation, patient involvement, implementation and the impact of COVID-19

Lee YK, Ng CJ, Lee PY, Tong WT, Sa'at H

Z Evid Fortbild Qual Gesundhwes, 2022 Jun;171:89-92.
PMID: 35610129 DOI: 10.1016/j.zefq.2022.04.020

Shared decision making (SDM) activities in Malaysia began around 2010. The rise in the numbers of patients with chronic disease in Malaysia underscores a growing need for doctors to practice patient-centred care and SDM as more Malaysians come into regular contact with health decision-making scenarios. Recent guidelines for medical professionalism have emphasized that options and risks be discussed in consultations, especially for procedures with risk of adverse outcomes. Although SDM is not legally required, principles of SDM are applied in legal judgements on informed consent. Research on SDM has grown to include the adoption of patient and public involvement in research, an increased emphasis on incorporating local cultural values in SDM, and implementation of SDM in Malaysia's health system and organizational culture. While COVID-19 hindered the progress of SDM research, one positive development was that vaccination choices heightened public consciousness about personal decisional autonomy and the need to discuss pros and cons with doctors before making a medical decision.
Advance Care Planning in Malaysia

Lim ZN, Ng WJ, Lee CC

Z Evid Fortbild Qual Gesundhwes, 2023 Aug;180:103-106.
PMID: 37357108 DOI: 10.1016/j.zefq.2023.05.019

BACKGROUND: In Malaysia, advance care planning is still in its infancy. There is no national implementation of Advance Care Planning.
AIMS: To describe the national state of advance care planning development in Malaysia METHODS: Review of relevant advance care planning literature locally and internationally was undertaken.
RESULTS: Positive development in Malaysia includes implementation of advance care planning at institutional level, initiatives to develop educational programmes as well as research activities to understand the attitude and perception of patients on advance care planning. However, there remain challenges, including lack of knowledge and awareness, lack of legislative framework to guide advance care planning implementation and lack of strong initiatives at a national level.
CONCLUSIONS: It is evident that there is much to learn nationally and internationally about ACP before any decision on implementation of ACP is made in Malaysia. ACP is a public health issue and requires concerted effort of all stakeholders, including Government agencies, academic institutions, and non-government organizations to raise public awareness. More research is needed to shape the future direction of ACP development in Malaysia.

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