@article{ART003383346},
author={Choi, Sang-Ji},
title={Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy},
journal={Korean Journal of Medical Ethics },
issn={2005-8284},
year={2026},
volume={29},
number={3},
pages={131-146}
TY - JOUR
AU - Choi, Sang-Ji
TI - Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy
JO - Korean Journal of Medical Ethics
PY - 2026
VL - 29
IS - 3
PB - The Korean Society For Medical Ethics
SP - 131
EP - 146
SN - 2005-8284
AB - Shared decision-making (SDM) is widely recognized for integrating clinical evidence with patientvalues, yet standard SDM models presuppose elective conditions: ample time, intact capacity,and repeated consultations. Emergency surgery for colorectal cancer, which typically arises fromobstruction, perforation, or hemorrhage, undermines these prerequisites. Irreversible, value-ladenchoices concerning stoma formation, the extent of resection, or non-operative care in frail olderpatients must be made within hours, often under impaired capacity due to pain, sepsis, and opioids.
Drawing on the perspective of a colorectal surgeon at a regional university hospital in South Korea,this article analyzes why standard SDM fails in this setting and argues that this shortfall mandatesreconstructing the SDM framework. Reinterpreting autonomy relationally, the study defendsstructured family participation as a legitimate expression of patient self-determination in the Koreancontext. It proposes a time-adapted SDM model that stratifies decisions by physiological urgency,incorporates the best-case/worst-case communication framework, utilizes bridging strategies suchas colonic stenting to render emergency choices semi-elective, and specifies the institutional anddocumentation supports required by regional medical centers.
KW - decision making;shared;colorectal neoplasms;emergencies;personal autonomy;enterostomy;professional-family relations
DO -
UR -
ER -
Choi, Sang-Ji. (2026). Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy. Korean Journal of Medical Ethics , 29(3), 131-146.
Choi, Sang-Ji. 2026, "Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy", Korean Journal of Medical Ethics , vol.29, no.3 pp.131-146.
Choi, Sang-Ji "Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy" Korean Journal of Medical Ethics 29.3 pp.131-146 (2026) : 131.
Choi, Sang-Ji. Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy. 2026; 29(3), 131-146.
Choi, Sang-Ji. "Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy" Korean Journal of Medical Ethics 29, no.3 (2026) : 131-146.
Choi, Sang-Ji. Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy. Korean Journal of Medical Ethics , 29(3), 131-146.
Choi, Sang-Ji. Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy. Korean Journal of Medical Ethics . 2026; 29(3) 131-146.
Choi, Sang-Ji. Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy. 2026; 29(3), 131-146.
Choi, Sang-Ji. "Shared Decision-Making in Emergency Colorectal Cancer Surgery: A Time-Adapted Model Grounded in Relational Autonomy" Korean Journal of Medical Ethics 29, no.3 (2026) : 131-146.
