Shared decision-making is a key aspect of patient-centered care. This study employed a bioethical framework to assess shared decision-making in conversations between urology fellows and patients about how to treat early stage prostate cancer. The authors argue that well-intentioned physicians fail to empower patients and recommend communication training for postgraduate physicians that includes tools like teach-back. A related editorial asserts that poor shared decision-making should be approached like other adverse events—examined with root cause analysis and treated as an opportunity for improvement.