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- Munthe, Christian, 1962, et al.
(författare)
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Disputing with patients in person-centered care: Ethical aspects in standard care, pediatrics, psychiatry, and public health
- 2018
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Ingår i: Journal of Argumentation in Context. - : John Benjamins Publishing Company. - 2211-4742 .- 2211-4750. ; 7:2, s. 231-244
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Tidskriftsartikel (refereegranskat)abstract
- This article explores ethical aspects of using open argumentation in person-centered care (PCC), where health professionals (HPs) openly criticize or contradict factual claims, assumptions, preferences, or value commitments of patients. We argue that such disputing may be claimed to have an important place in advanced versions of PCC, but that it actualizes important clinical ethical aspects of doing such disputation well. This may prompt caution in the implementation of PCC, but also inspire educational and organizational reform. We also probe the notion of openly disputing with patients when PCC is applied in less standard settings (where it is nevertheless advocated), using the cases of children, psychiatry, and public health interventions, such as antibiotic stewardship programs, as examples. These contexts offer new reasons for why PCC may or should include open disputing with patients, but also introduce new ethical complications. Some of these may transform either to arguments against PCC implementation in these areas, or to a more open view of the extent a HP may seek to dominate patients in a PCC setting. We are especially skeptical of the meaningfulness of applying advanced PCC in areas of psychiatry with high levels of compulsory elements, such as forensic psychiatric detention.
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| 3. |
- Munthe, Christian, 1962, et al.
(författare)
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Questioning the patient in person centred care: ethical aspects: children, forensic psychiatry, and public health
- 2017
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Ingår i: Medical Argumentation and Patient Centred Care, University of Amsterdam, October 26-27, 2017..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The paper explores the room, both conceptually and ethically, for questioning, contradicting and adapting positions to patients in three specific areas: care of patients with vulnerable cpapcities for taking responsibility (adolescents and psychiatry), contexts of constrained autonomy (forensic care), and public health (antobiotic resistance stewardship and vaccination). These areas in various ethically relevant ways exhibit non-standard settings, compared to usual assumptions about the nature of patients and institutional contexts made when person centredness and shared decision-making are held out as primarily emancipating concepts. The paper probes to what extent that ethical idea may be maintained also in such non-standard settings.
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