The Patient as Agent of Health and Health Care

Autonomy in Patient-Centered Care for Chronic Conditions

Nonfiction, Health & Well Being, Medical, Patient Care, Physician & Patient, Reference, Ethics
Cover of the book The Patient as Agent of Health and Health Care by Mark Sullivan, MD, PhD, Oxford University Press
View on Amazon View on AbeBooks View on Kobo View on B.Depository View on eBay View on Walmart
Author: Mark Sullivan, MD, PhD ISBN: 9780190651329
Publisher: Oxford University Press Publication: December 15, 2016
Imprint: Oxford University Press Language: English
Author: Mark Sullivan, MD, PhD
ISBN: 9780190651329
Publisher: Oxford University Press
Publication: December 15, 2016
Imprint: Oxford University Press
Language: English

Patient-centered care for chronic illness is founded upon the informed and activated patient, but we are not clear what this means. We must understand patients as subjects who know things and as agents who do things. Bioethics has urged us to respect patient autonomy, but it has understood this autonomy narrowly in terms of informed consent for treatment choice. In chronic illness care, the ethical and clinical challenge is to not just respect, but to promote patient autonomy, understood broadly as the patients' overall agency or capacity for action. The primary barrier to patient action in chronic illness is not clinicians dictating treatment choice, but clinicians dictating the nature of the clinical problem. The patient's perspective on clinical problems is now often added to the objective-disease perspective of clinicians as health-related quality of life (HRQL). But HRQL is merely a hybrid transitional concept between disease-focused and health-focused goals for clinical care. Truly patient-centered care requires a sense of patient-centered health that is perceived by the patient and defined in terms of the patient's vital goals. Patient action is an essential means to this patient-centered health, as well as an essential component of this health. This action is not extrinsically motivated adherence, but intrinsically motivated striving for vital goals. Modern pathophysiological medicine has trouble understanding both patient action and health. The self-moving and self-healing capacities of patients can be understood only if we understand their roots in the biological autonomy of organisms. Taking the patient as the primary perceiver and producer of health has the following policy implications: 1] Care will become patient-centered only when the patient is the primary customer of care. 2] Professional health services are not the principal source of population health, and may lead to clinical, social and cultural iatrogenic injury. 3] Social justice demands equity in health capability more than equal access to health services.

View on Amazon View on AbeBooks View on Kobo View on B.Depository View on eBay View on Walmart

Patient-centered care for chronic illness is founded upon the informed and activated patient, but we are not clear what this means. We must understand patients as subjects who know things and as agents who do things. Bioethics has urged us to respect patient autonomy, but it has understood this autonomy narrowly in terms of informed consent for treatment choice. In chronic illness care, the ethical and clinical challenge is to not just respect, but to promote patient autonomy, understood broadly as the patients' overall agency or capacity for action. The primary barrier to patient action in chronic illness is not clinicians dictating treatment choice, but clinicians dictating the nature of the clinical problem. The patient's perspective on clinical problems is now often added to the objective-disease perspective of clinicians as health-related quality of life (HRQL). But HRQL is merely a hybrid transitional concept between disease-focused and health-focused goals for clinical care. Truly patient-centered care requires a sense of patient-centered health that is perceived by the patient and defined in terms of the patient's vital goals. Patient action is an essential means to this patient-centered health, as well as an essential component of this health. This action is not extrinsically motivated adherence, but intrinsically motivated striving for vital goals. Modern pathophysiological medicine has trouble understanding both patient action and health. The self-moving and self-healing capacities of patients can be understood only if we understand their roots in the biological autonomy of organisms. Taking the patient as the primary perceiver and producer of health has the following policy implications: 1] Care will become patient-centered only when the patient is the primary customer of care. 2] Professional health services are not the principal source of population health, and may lead to clinical, social and cultural iatrogenic injury. 3] Social justice demands equity in health capability more than equal access to health services.

More books from Oxford University Press

Cover of the book Un-American Activities by Mark Sullivan, MD, PhD
Cover of the book Cognitive-Behavioral Stress Management by Mark Sullivan, MD, PhD
Cover of the book Christianity, Islam, and Liberal Democracy by Mark Sullivan, MD, PhD
Cover of the book Information Graphics by Mark Sullivan, MD, PhD
Cover of the book Trading and Exchanges:Market Microstructure for Practitioners by Mark Sullivan, MD, PhD
Cover of the book Experiencing Art by Mark Sullivan, MD, PhD
Cover of the book Thomas Harriot by Mark Sullivan, MD, PhD
Cover of the book Strategies for Success in Musical Theatre by Mark Sullivan, MD, PhD
Cover of the book Silent Victories by Mark Sullivan, MD, PhD
Cover of the book The Psychotherapist's Own Psychotherapy by Mark Sullivan, MD, PhD
Cover of the book Race and the Modern Artist by Mark Sullivan, MD, PhD
Cover of the book Classical Traditions in Modern Fantasy by Mark Sullivan, MD, PhD
Cover of the book The Phantom of the Opera - With Audio Level 1 Oxford Bookworms Library by Mark Sullivan, MD, PhD
Cover of the book The Caribbean before Columbus by Mark Sullivan, MD, PhD
Cover of the book Schooling New Media by Mark Sullivan, MD, PhD
We use our own "cookies" and third party cookies to improve services and to see statistical information. By using this website, you agree to our Privacy Policy