同為高齡化社會的臺灣與日本，隨著高齡的慢性病人增加由早期以醫師主導單向決策（亦稱父權模式），到重視病人決策意識提升。本案例兩家個案醫院推行醫病共享決策的過程均面臨挑戰，無論臺灣的「變革理論」採漸進式推進，或日本的集體共識「學習會」，均著眼在「溝通」上起了作用。良好的溝通讓醫護人員理解病人與家屬的需求及瞭解不同治療方案的利弊，從而協助做出知情的選擇。實施醫病共享決策的過程中，除醫師、護理師以及病人、家屬之間的多方交流尤為重要外，對病人選擇權的尊重，更提升醫療服務品質。從案例中，臺灣著重於推行院內的落實，而日本則儘可能的消弭病人的資訊不平等。

As aging societies in democratic countries, both Taiwan and Japan face challenges in implementing shared decision making (SDM) within their healthcare systems, as demonstrated by the experiences of their respective chambers in this case study. Whether through Taiwan’s gradual approach or through Japan’s pursuit of collective consensus, the emphasis on communication remains central. Effective communication enables healthcare professionals to understand the needs of their patients. It also helps patients understand the advantages and disadvantages of different treatment options, which in turn supports informed decision-making. In the SDM process, communication between physicians, nurses, patients, and their families is crucial. In addition, respecting the patient’s right to choose their treatment modality and enhancing the quality of healthcare services are emphasized. The difference between Taiwan and Japan is that Taiwan emphasizes institutional implementation, whereas Japan seeks to minimize the informational inequality faced by patients.