Medicine, Health Care and Philosophy 15 (2):115-127 (2012)
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Abstract |
In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What this implies in terms of the importance that we have reason to attach to (non-)adherence and how has, however, not been explained. In this article, we explore the relationship between different forms of shared decision-making, patient autonomy and adherence. Distinguishing between dynamically and statically framed adherence we show how the version of shared decision-making advocated will have consequences for whether one should be interested in a dynamically or statically framed adherence and in what way patient adherence should be assessed. In contrast to the former compliance paradigm (where non-compliance was necessarily seen as a problem), using observations about (non-)adherence to assess the success of health care decision making and professional-patient interaction turns out to be a much less straightforward matter.
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Keywords | Adherence Compliance Patient autonomy Patient best interest Shared decision-making |
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Reprint years | 2012 |
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DOI | 10.1007/s11019-011-9336-x |
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References found in this work BETA
Shared Decision Making, Paternalism and Patient Choice.Lars Sandman & Christian Munthe - 2010 - Health Care Analysis 18 (1):60-84.
Shared Decision-Making and Patient Autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
The Goals of Public Health: An Integrated, Multidimensional Model.Christian Munthe - 2008 - Public Health Ethics 1 (1):39-52.
The Concept of Negotiation in Shared Decision Making.Lars Sandman - 2009 - Health Care Analysis 17 (3):236-243.
View all 8 references / Add more references
Citations of this work BETA
Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research.Christian Munthe, Lars Sandman & Daniela Cutas - 2012 - Health Care Analysis 20 (3):231-249.
Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?Leila El-Alti, Lars Sandman & Christian Munthe - 2019 - Health Care Analysis 27 (1):45-59.
Health-Care Needs and Shared Decision-Making in Priority-Setting.Erik Gustavsson & Lars Sandman - 2015 - Medicine, Health Care and Philosophy 18 (1):13-22.
Patients' Participation in Decision-Making in the Medical Field - ‘Projectification’ of Patients in a Neoliberal Framed Healthcare System.Stinne Glasdam, Christine Oeye & Lars Thrysoee - 2015 - Nursing Philosophy 16 (4):226-238.
Individual Responsibility as Ground for Priority Setting in Shared Decision-Making.Lars Sandman, Erik Gustavsson & Christian Munthe - 2016 - Journal of Medical Ethics 42 (10):653-658.
View all 13 citations / Add more citations
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