Patients’ participation in decision-making in the medical field – ‘projectification’ of patients in a neoliberal framed healthcare system
Author
Summary, in English
This article focuses on patients’ participation in decision-making in meetings
with healthcare professionals in a healthcare system, based on neoliberal
regulations and ideas.Drawing on two constructed empirical cases,
primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a
Foucauldian perspective. Patients’ participation in decision-making can
be seen as an offshoot of respect for patient autonomy. A treatment must
be chosen, when patients consult physicians. From the perspective of
patients, there is a tendency for healthcare professionals to supply the
patients with the information that they think are necessary for them to
make their own decision. But patients do not always want to be a ‘customer’ in the healthcare system; they want to be a patient, consulting an expert for help and advice,which creates resistance to some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A‘projectification’ of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own situations from a humanistic perspective.
with healthcare professionals in a healthcare system, based on neoliberal
regulations and ideas.Drawing on two constructed empirical cases,
primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a
Foucauldian perspective. Patients’ participation in decision-making can
be seen as an offshoot of respect for patient autonomy. A treatment must
be chosen, when patients consult physicians. From the perspective of
patients, there is a tendency for healthcare professionals to supply the
patients with the information that they think are necessary for them to
make their own decision. But patients do not always want to be a ‘customer’ in the healthcare system; they want to be a patient, consulting an expert for help and advice,which creates resistance to some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A‘projectification’ of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own situations from a humanistic perspective.
Department/s
Publishing year
2015
Language
English
Pages
226-238
Publication/Series
Nursing Philosophy
Volume
16
Issue
4
Full text
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Links
Document type
Journal article
Publisher
Wiley-Blackwell
Topic
- Health Care Service and Management, Health Policy and Services and Health Economy
Keywords
- particitation
- patient
- decision-making
- medical field
- neoliberal frame.
Status
Published
Research group
- Integrative Health Research
ISBN/ISSN/Other
- ISSN: 1466-7681