Yuanqi Yang

Shared Decision-Making (SDM) is widely regarded not merely as a cornerstone of contemporary medical ethics, but also as a central construct within modern clinical practice and healthcare governance. It aims to integrate medical expertise with patients’ values and lived experiences. Yet its implementation often encounters two persistent obstacles: power imbalances, in which physicians control the timing, rhythm, and content of communication, and epistemic asymmetries, in which professional medical knowledge is privileged over patients’ first-person experiences. These asymmetries not only restrict patients’ participation but also distort the reciprocity necessary for genuine collaboration. To examine these challenges, this paper draws on Husserl’s transcendental person theory and the dynamic reversibility between natural and transcendental attitudes to develop a phenomenological physician attitude-switching framework. Within this framework, physicians alternate between a natural attitude, in which diseases are understood within biomedical objectivity, and a transcendental attitude, in which illness is interpreted as an existential condition embedded in personal, cultural, and ethical contexts. Oscillation between these stances enables physicians to both preserve diagnostic rigor and remain responsive to patients’ vulnerability, subjectivity, and moral agency. The paper further develops the ethical implications of this framework, illustrating its practical utility through a representative case study in autism care, where the balance between medical authority and patient experience is particularly fragile.