I think this ignores the diverse uses of the term "decision" and the verb "decide." Surely not all of the following are the same?
I decided to take an aspirin to reduce my chance of heart disease.
I decided to go to the doctor.
I decided to take a deep breath.
I decided to perform CPR on this bystander in the street.
I decided to forgo resuscitation if my heart should stop.
I decided to quit smoking.
It must be that these involve various shadings of the word decision, a different mix of voluntary, quasi-voluntary, outwardly imposed, and preference-sensitive action. If we are to further care that is consonant with peoples' preferences, we should recognize that sometimes these preference are at the fore in a given decision ("I decided to walk 2 miles every week!") and sometimes not ("I decided to take time off work to take care of my mother"). There are differences that should be recognized, and eliding them runs the risk of dismissing when preferences might actually be most important.