| 1. Formation of Partnership | 1.1. Equal relationship between the patient and the doctor1.2. Active participation of patients |
| 2. Exchange of information | 2.1. Provision of medical information2.2. Providing medical facts about predicted outcomes2.3. Providing treatment options and harms and benefits of options2.4. Sharing information among medical staff2.5. Using patient decision aids2.6. Identify the patient’s decision-making ability2.7. Identify the patient’s preferences and values2.8. Leading the patient’s thoughts and concerns2.9. Check the patient’s understanding and acceptance |
| 3. Deliberation | 3.1. Repeated discussion3.2. Providing enough time3.3. Resolution of conflict problems3.4. Expanding the number of decision-making participants3.5. If necessary, expert intervention |
| 4. Mutual decision-making | 4.1. Mutually agreed decision and respect4.2. Decision supported by understanding4.3. Share the decision among the participants4.4. Establishment of advanced care plan |
| 5. Periodic review and confirmation | 5.1 Review process after decision5.2. Periodic review5.3. Re-confirmation of end-of-life |