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Shared decision making describes an approach to medical decision making that lies between paternalism and autonomy [1]. This model of decision making, described recently as the ‘pinnacle of patient-centered care’ [2] is quickly becoming the preferred approach to medical decisions, where there is no one ‘best’ treatment option. In these circumstances, involvement of patients in decision making helps us to ensure that treatment decisions reflect the patient's preferences and values.

The patient perspective and physician's role in making decisions on instituting dialysis