How to Assess & Slow Down Medical Decision Making…Using your “BRAIN”

Modern healthcare moves fast.

Appointments are short.

Recommendations seem confident.

Protocols are standardized.

You feel like there is either too little or too much information.

And somewhere in the middle of that, you’re expected to decide.

Whether you’re facing surgery, navigating a new diagnosis, managing chronic illness, or making decisions in labor and delivery...patient advocacy starts with slowing the conversation down.

And before we even get to the BRAIN framework, we need to anchor in this:

Bodily Autonomy Is Not Permission-Based

Bodily autonomy means you do not need to be “allowed” to do something with your own body.

You are the sole decision-maker.

Medical providers are highly trained professionals, but they are providing a service. They offer expertise, recommendations, data, and clinical experience. You provide consent.

That dynamic matters.

You are not asking for permission to decline a medication.

You are not asking for permission to wait.

You are not asking for permission to ask questions.

You are hiring expertise to inform your decision.

That’s what informed consent actually is.

And one of the most effective tools for informed medical decision-making is the BRAIN framework.

The BRAIN Tool for Patient Advocacy

BRAIN works in hospitals, outpatient clinics, specialist offices, and birth rooms. It slows the moment down and gives you structure when pressure is high.

B is for Benefits

When a provider recommends a treatment, procedure, or intervention, the conversation often starts with the benefits.

But strong patient advocacy asks:

* What are the benefits?

* Benefits for what outcome?

* Benefits for quality of life?

* Benefits short-term or long-term?

In other healthcare settings:

* What are the benefits of starting this medication now?

* What are the benefits of surgery versus conservative treatment?

* What measurable improvement should I expect?

In maternity care, this might sound like:

* What are the benefits of induction for labor?

* What are the benefits for the baby?

* What are the benefits for the birthing person?

Benefits should be specific, not vague reassurance.

R is for Risks

No medical intervention is risk-free.

Not medication.

Not surgery.

Not epidurals.

Not cesareans.

Not even doing nothing.

But the word “risk” without numbers and context creates fear.

Ask:

* What are the risks?

* How common are they?

* What are the percentages?

* How do these risks apply to my specific health profile?

“Increased risk” can sound terrifying. But an increase from 1% to 1.5% is very different than 1% to 20%.

In birth, someone pursuing a VBAC may be told about an increased risk of uterine rupture. Without context, that sounds catastrophic. With actual statistics, often around a 0.05% increase above baseline, the conversation becomes grounded and evidence-based.

Risk deserves transparency, not intimidation.

A is for Alternatives

This is where autonomy is either protected or quietly eroded.

When a provider presents one plan confidently, it can feel like the only option. But many non-emergent medical decisions have alternatives.

Ask:

* What are my other options?

* Can we try something less invasive first?

* What happens if we monitor instead?

* Is there a different medication?

* Can I get a second opinion?

In general healthcare, alternatives might include:

* Physical therapy before orthopedic surgery

* Lifestyle changes before starting medication

* A different dosage or medication class

* Watchful waiting

* A referral to a specialist

In maternity care, alternatives may include:

* Intermittent fetal monitoring instead of continuous monitoring

* Position changes and movement before epidural

* Expectant management before induction when medically appropriate

Not every situation has alternatives - but many do.

You don’t lose anything by asking.

I is for Information, Intuition & Indications

Information

If you don’t understand what’s happening in your body, you cannot give informed consent.

Ask for:

* Clear explanations in plain language

* Absolute risk versus relative risk

* Lab and imaging interpretation

* Research behind the recommendation

* What happens if you delay

You are not “difficult” for wanting clarity.

Intuition

Your body is not separate from you.

Patients often sense when something feels rushed, misaligned, or incomplete. Others sense when something truly feels urgent.

In chronic illness, patients often notice symptom shifts before labs show them.

In labor, birthing people frequently feel changes before monitors reflect them.

Intuition should not replace medical expertise, but it absolutely belongs in the conversation.

Indications

Is this recommendation specific to your individual condition?

Or is it standard protocol?

For example:

* If blood pressure is elevated, treatment depends on severity, symptoms, and overall cardiovascular risk.

* If membranes rupture in pregnancy, next steps depend on infection risk, GBS status, and contraction patterns.

Personalized care matters. Protocol is not the same as individualized medicine.

N is for Nothing or Next

This question alone can completely shift a medical conversation:

* What happens if I do nothing right now?

* Is this urgent?

* If I move forward, what happens next?

* If that doesn’t work, what’s the next step after that?

Many interventions begin a cascade. That doesn’t mean they’re wrong, but you deserve to see the full pathway before stepping onto it.

Sometimes “doing nothing” means:

* Monitoring

* Repeating labs

* Getting a referral or 2nd opinion

* Waiting for labor to begin naturally

* Trying conservative management

Sometimes waiting is risky.

Sometimes waiting is wise.

You deserve to know which one applies to you.

Emergency vs. Non-Emergency

True emergencies feel different.

Rooms fill quickly.

Staff move decisively.

Communication becomes direct.

Outside of that?

There is usually time.

Time to:

* Ask questions

* Step out of the room

* Call a support person

* Review consent forms carefully

* Request clarification

Slowing down medical decision-making is not being oppositional.

It is exercising bodily autonomy.

Reframing the Power Dynamic in Healthcare

You are not a passive recipient of care.

You are the one living in your body.

You are the one who experiences the outcomes.

You are the one who carries the long-term impact.

Medical professionals bring expertise.

You bring authority over your body.

When those two work together, that’s collaborative care.

When questions are discouraged or rushed, autonomy is compromised.

The goal is not to reject medical care. The goal is to participate in it fully informed.

Final Thoughts

Patient advocacy is not about saying no to everything.

It’s about:

* Slowing down.

* Asking better questions.

* Understanding stated risks and benefits.

* Exploring alternatives.

* Trusting your intuition.

* Knowing what happens next.

* Remembering that consent is yours to give or not give.

Whether you’re preparing for childbirth, considering surgery, starting medication, or navigating a new diagnosis, the BRAIN framework protects your autonomy and strengthens informed medical decision-making.

You do not need permission to make choices about your body.

You need information.

And time.

And the confidence to use both.