Equality, Liberty and the Limits of Person-centred Care’s Principle of Co-production

Public Health Ethics 12 (2):176-187 (2019)
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The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like equality and liberty. Regarding equality, I argue that co-production compounds both problems of gender inequality in the distribution of care labour and the challenges associated with securing equal access to care. Turning to liberty, I identify important commonalities between co-production and republicanism in political philosophy, given their shared insistence on common citizens’ civic virtue. Then, I use against co-production some liberal arguments against republicanism, to highlight a problem of over-demandingness. In bringing my argument to a close, however, I wish to caution against hastily rejecting co-production as a policy programme.

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Gabriele Badano
University of York

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References found in this work

Republicanism: a theory of freedom and government.Philip Pettit (ed.) - 1997 - New York: Oxford University Press.
Just Health: Meeting Health Needs Fairly.Norman Daniels - 2007 - Cambridge University Press.
Justice, Gender and the Family.Susan Moller Okin - 1989 - Hypatia 8 (1):209-214.
Republicanism: A Theory of Freedom and Government.Philip Pettit - 1999 - Philosophical Quarterly 49 (196):415-419.
Justice, Gender, and the Family.Martha L. Fineman - 1991 - Philosophy and Public Affairs 20 (1):77-97.

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