Any MDT approach should always have each individual Patient's views on their care / needs at the centre of any decisions made. 

"Nothing about me without me" is always something I have in the back of my mind. When I have completed an assessment, I always provide the patient with a summary of the visit / assessment, what we have discussed and the action plans either for the patient / family to do and those for myself. 

It makes the process clear, and transparent, but also puts some level of control to the patient so they know what I am doing for them, and have something in writing that enables them to keep / pass to other professionals. 

In terms of decisions, it always goes back to the whether the patient has capacity and the insight into consequences of decisions they are making. If they do, we are not there to judge, but to guide, respect and support. Guide the patient in terms of ensuring they have all information available to make an informed decision. Respect decisions they do make, and support them with these decisions. 

I guess examples I can reflect on are following ACP discussions when patients have informed me that they do not wish for RIG / PEG insertion. My job isn't to make that decision for them, but to ensure they have all the information available to make an informed decision. If following discussions they do not want a referral for RIG / PEG, ensuring they have capacity to make this decision and ensuring they understand the consequences of this decision. I will then ensure it is documented, and shared with the wider MDT. 

Another example I can reflect on is to do with mobility / transferring. I had a patient who had capacity and was being carried up the stairs, and although this was unsafe in terms of practice and put her and her Husband at risk, they both had the capacity and understood the consequences of this poor Moving and handling technique. 

I also feel that good MDT working is respecting other professionals judgement about situations they may encounter.