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Göteborgs universitets publikationer

The Counseling, Self-care, Adherence Approach to Person-centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-dimensional Care Decisions

Författare och institution:
Anders Herlitz (Institutionen för filosofi, lingvistik och vetenskapsteori); Christian Munthe (Institutionen för filosofi, lingvistik och vetenskapsteori); Marianne Törner (Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa); Gun Forsander (Institutionen för kliniska vetenskaper, sektionen för kvinnors och barns hälsa, Avdelningen för pediatrik)
Publicerad i:
Health Communication, 31 ( 8 ) s. 964-973
ISSN:
1041-0236
E-ISSN:
1532-7027
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Fulltextlänk (lokalt arkiv):
Sammanfattning (abstract):
This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Endokrinologi och diabetes ->
Diabetologi
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Pediatrik
MEDICIN OCH HÄLSOVETENSKAP ->
Hälsovetenskaper ->
Omvårdnad
MEDICIN OCH HÄLSOVETENSKAP ->
Hälsovetenskaper ->
Medicinsk etik
MEDICIN OCH HÄLSOVETENSKAP ->
Annan medicin och hälsovetenskap
SAMHÄLLSVETENSKAP ->
Psykologi ->
Tillämpad psykologi
HUMANIORA ->
Filosofi, etik och religion ->
Filosofi ->
Praktisk filosofi
HUMANIORA ->
Filosofi, etik och religion ->
Etik
Nyckelord:
Person-centered Care, Shared Decision-making, Moral Psychology, Diabetes Care, Adolescents, Self-care, Adherence, Ethics, Bioethics, Autonomy, Decision Capacity
Postens nummer:
230638
Posten skapad:
2016-01-14 12:17
Posten ändrad:
2016-05-29 20:25

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