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Patients’ participation in decision-making in the medical field – ‘projectification’ of patients in a neoliberal framed healthcare system

Glasdam, Stinne LU ; Øye, Christine and Thryssøe, Lars (2015) In Nursing Philosophy 16(4). p.226-238
Abstract
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... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
particitation, patient, decision-making, medical field, neoliberal frame.
in
Nursing Philosophy
volume
16
issue
4
pages
226 - 238
publisher
Wiley-Blackwell
external identifiers
  • wos:000364540300006
  • scopus:84946171556
ISSN
1466-7681
DOI
10.1111/nup.12092
language
English
LU publication?
yes
id
57793c12-60ca-4c44-90bc-fed3a397ffc6 (old id 5367146)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/?term=25943450
date added to LUP
2015-05-07 15:41:58
date last changed
2017-07-23 03:02:46
@article{57793c12-60ca-4c44-90bc-fed3a397ffc6,
  abstract     = {This article focuses on patients’ participation in decision-making in meetings<br/><br>
with healthcare professionals in a healthcare system, based on neoliberal<br/><br>
regulations and ideas.Drawing on two constructed empirical cases,<br/><br>
primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a<br/><br>
Foucauldian perspective. Patients’ participation in decision-making can<br/><br>
be seen as an offshoot of respect for patient autonomy. A treatment must<br/><br>
be chosen, when patients consult physicians. From the perspective of<br/><br>
patients, there is a tendency for healthcare professionals to supply the<br/><br>
patients with the information that they think are necessary for them to<br/><br>
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.},
  author       = {Glasdam, Stinne and Øye, Christine and Thryssøe, Lars},
  issn         = {1466-7681},
  keyword      = {particitation,patient,decision-making,medical field,neoliberal frame.},
  language     = {eng},
  number       = {4},
  pages        = {226--238},
  publisher    = {Wiley-Blackwell},
  series       = {Nursing Philosophy},
  title        = {Patients’ participation in decision-making in the medical field – ‘projectification’ of patients in a neoliberal framed healthcare system},
  url          = {http://dx.doi.org/10.1111/nup.12092},
  volume       = {16},
  year         = {2015},
}