Traditionally, medical care is mainly guided by professional medical personnel. In the recent 2 to 3 decades, the concept of patient-centered medical care emerges. Patient autonomy is increasingly involved in making medical decisions. More and more patient rights are also claimed during examination and treatment process. It has been supported by government agencies, expert groups and patients. Pre-consultation and communication between doctors and patients to achieve a shared-decision making in health care has set a milestone in the new era of medical care Shared decision-making (SDM) is highly recommended by health agencies in many countries. Under the promotion policy by Joint Commission of Taiwan (JCT), many SDM models have been launched in Taiwan, and moving with great momentum. Medical ethics experts argue for patient autonomy, and physicians are not allowed to attempt to change patients' preferences and values. A good SDM policy can increase patient autonomy and implement human rights, reduce unnecessary examinations, reduce medical costs, and improve the quality and satisfaction of care. However, there are variations in clinical situation and also a big gap in professional knowledge among doctors, medical teams, patients and family, etc. Therefore, it remains a big challenge whether doctors and/or patients will take part in SDM process actively and achieves appropriate outcomes. This is the main issue discussed in this article, especially the challenge of practicingshared decision-making in surgery.