Communication, compassion, and shared decision-making in allergy.

Shared decision-making (SDM) is a structured approach to clinical care that integrates the best available evidence, clinician expertise, and patient values. Although SDM frameworks are well described, comparatively little attention has been paid to the role of humanistic compassion in shaping the quality of these encounters. This narrative review evaluates the intersection of SDM and compassionate communication in allergy practice, with a particular focus on food allergy examples. Evidence from asthma demonstrates that SDM improves quality of life, disease control, medication adherence, and health care utilization, whereas broader literature links compassionate care to improved trust, adherence, clinician well-being, and reduced burnout. Food allergy represents a particularly salient context for SDM given preference-sensitive decisions surrounding, for example, oral immunotherapy and evolving approaches to at-home anaphylaxis management. Structural determinants of health, misinformation, and emerging technologies such as artificial intelligence further complicate contemporary allergy care and underscore the need for relational competence alongside technical expertise. This article reviews implementation frameworks, including system-level approaches to embedding SDM into routine care and highlights equity-informed strategies to ensure that decisions are both values aligned and realistically achievable. Ultimately, SDM and compassion are not adjuncts to evidence-based allergy care but essential components of its effective and ethical delivery.