In order to optimize the decision making process, all reasonable options should be presented to the patient including the option of NOT TO OPERATE. The pros and cons of each option should be discussed so that a patient can make an INFORMED DECISION regarding their treatment. The decision to treat must be made in conjunction with both the surgeon and the patient together. 

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The shared decision making process in the diagram below is to optimize treatment outcomes for the individual patient. What may serve one patient may not serve another even for the same condition. Factors must be taken into account such as patient desires, risk tolerance, medical conditions, social and financial resources. I will endeavour to take these into account when formulating your treatment plan.