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