Objective: The COVID-19 pandemic pushed some of the most well-developed healthcaresystems to their limits. In many cases, this has challenged patient-centered care. We set out toexamine individuals’ attitudes towards shared decision making (SDM) and to identifypredictors of participation preference during the pandemic.Methods: We conducted an online survey with a large convenience sample (N = 1061). Ourmain measures of interest were participants’ generic and COVID-19 related participationpreferences, and their acceptance and distress regarding a triage vignette. We also assessedanxiety, e-health literacy, and aspects of participants’ health. We conducted groupcomparisons and multiple linear regression analyses on participation preference and triageacceptance.Results: In generic decision making, most participants expressed a strong need forinformation and a moderate participation preference. In the hypothetical case of COVID-19infection, the majority preferred physician-led decisions. Generic participation preference wasthe strongest predictor for COVID-19 related participation preference, followed by age,education and anxiety. Furthermore, higher generic and COVID-19 related participationpreferences both predicted lower triage acceptance.Conclusion: Our findings demonstrate potential healthcare recipients’ attitudes towards SDMduring a severe healthcare crisis and emphasize that participation preference varies accordingto the context.