The insidious cruelty of RFK Jr's deceptive CDC changes to child inoculation advisories

[Pluvious]

Shared decision-making, informed consent, and the rhetoric of false empowerment

What these medical terms mean and how they’re fueling confusion about vaccines

Recently, RFK Jr. made sweeping changes to routine childhood immunization recommendations in the U.S., with more changes likely to come next month. Many of these changes have centered on medical phrases such as “shared clinical decision-making” or “informed consent.” While these phrases may sound like empowerment on the surface, they’re creating confusion and obscuring what’s actually happening.

So here’s a breakdown for you: What do these phrases actually mean in the medical world? Where’s the rhetorical twist leading to confusion and distrust? And importantly, whether you're a clinician, community leader, health department, or parent talking to other parents, what's the best way to talk about this?

Shared clinical decision-making (SCDM)

What it means in the medical world: On the surface, this phrase sounds like it means “involving patients (and parents) in decision-making.” But, perhaps counterintuitively, this face-value definition is not how the phrase is typically used in the medical world. SCDM doesn’t refer to parental authority to make decisions about their child’s health—parents are the decision-makers for all their child’s health care decisions, including vaccination, regardless of the SCDM label.

Instead, when a doctor says “shared clinical decision-making,” they’re usually referring to something very specific: a situation where the medical evidence does not give one clear recommendation, and there are multiple treatment options to choose from. When that happens, “shared clinical decision-making” is how physicians approach walking the patient through the different treatment options to come to a decision.

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https://yourlocalepidemiologist.substack.com/p/shared-decision-making-informed-consent