Health Care Analysis 20 (3):268-280 (2012)
|Abstract||This paper considers proposals for developing ‘co-productive’ medical partnerships, within the UK National Health Service (NHS), concentrating in particular on the potential problem involved in combining professional and lay conceptions of health. Much of the literature that advocates the introduction of co-productive healthcare partnerships assumes that medical professionals and patients share, or can easily come to share, a common set of beliefs about what is valuable with regard to health interventions and outcomes. However, a substantial literature documents the contestability of the concept of health, particular across professional and lay divides. We suggest that this potential disagreement ought to be taken seriously, and suggest that the prospect of a co-productive NHS in which patients and professionals act in partnership is threatened by the existence of unresolved epistemic differences. We suggest that part of the solution may lie in re-framing this potential disagreement in the terms provided by Engel’s bio-psycho-social account of health, and demonstrate how support for this account can be grounded upon a critical realist foundation. What we call a ‘stratified conception of health’ reveals the potential complementarity between health beliefs which may have at first seemed to be essentially contradictory. We consider some of the practical implications this idea has for conceiving and creating co-productive medical partnerships|
|Keywords||Bio-psycho-social Co-production Critical realism Medical partnership NHS Patient choice Personalisation Shared decision making|
|Categories||categorize this paper)|
|Through your library||Configure|
Similar books and articles
Matt Commers (2002). Determinants of Health: Theory, Understanding, Portrayal, Policy. Kluwer Academic Publishers.
Martin Benjamin (1985). Lay Obligations in Professional Relations. Journal of Medicine and Philosophy 10 (1):85-103.
Norman Daniels (2008). Just Health: Meeting Health Needs Fairly. Cambridge University Press.
Jozsef Kovács (1989). Concepts of Health and Disease. Journal of Medicine and Philosophy 14 (3):261-267.
Alan Cribb (2005). Health and the Good Society: Setting Healthcare Ethics in Social Context. Oxford University Press.
Mark Henaghan (2011). Health Professionals and Trust: The Cure for Healthcare Law and Policy. Routledge-Cavendish.
Gavin H. Mooney & Alistair McGuire (eds.) (1988). Medical Ethics and Economics in Health Care. Oxford University Press.
Neil Arya & Joanna Santa Barbara (eds.) (2008). Peace Through Health: How Health Professionals Can Work for a Less Violent World. Kumarian Press.
Christopher Boorse (1977). Health as a Theoretical Concept. Philosophy of Science 44 (4):542-573.
William H. Bruening (1992). Autonomy and Futility. HEC Forum 4 (5):305-313.
Samuel Gorovitz (1982/1985). Doctors' Dilemmas: Moral Conflict and Medical Care. Oxford University Press.
Halvor Nordby (2008). Medical Explanations and Lay Conceptions of Disease and Illness in Doctor–Patient Interaction. Theoretical Medicine and Bioethics 29 (6):357-370.
Ingemar Nordin (1999). The Limits of Medical Practice. Theoretical Medicine and Bioethics 20 (2):105-123.
Rosemarie Tong (1995). Towards a Just, Courageous, and Honest Resolution of the Futility Debate. Journal of Medicine and Philosophy 20 (2):165-189.
Added to index2011-07-20
Total downloads3 ( #213,250 of 722,787 )
Recent downloads (6 months)1 ( #60,541 of 722,787 )
How can I increase my downloads?