The Re-contextualization of the Patient: What Home Health Care Can Teach Us About Medical Decision-Making

HEC Forum 27 (2):143-156 (2015)

Abstract
This article examines the role of context in the development and deployment of standards of medical decision-making. First, it demonstrates that bioethics, and our dominant standards of medical decision-making, developed out of a specific historical and philosophical environment that prioritized technology over the person, standardization over particularity, individuality over relationship and rationality over other forms of knowing. These forces de-contextualize the patient and encourage decision-making that conforms to the unnatural and contrived environment of the hospital. The article then explores several important differences between the home health care and acute care settings. Finally, it argues that the personalized, embedded, relational and idiosyncratic nature of the home is actually a much more accurate reflection of the context in which real people make real decisions. Thus, we should work to “re-contextualize” patients, in order that they might be better equipped to make decisions that harmonize with their real lives.
Keywords Clinical ethics  Medical decision-making  Home health care  Individualism
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DOI 10.1007/s10730-015-9268-6
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References found in this work BETA

Utilitarianism.John Stuart Mill - 2009 - In Steven M. Cahn (ed.), Exploring Philosophy: An Introductory Anthology. Oxford University Press.
Liberalism and the Limits of Justice.Michael Sandel - 2003 - In Derek Matravers & Jonathan E. Pike (eds.), Journal of Philosophy. Routledge, in Association with the Open University. pp. 336-343.
Autonomy and Trust in Bioethics.Onora O'Neill - 2002 - Cambridge University Press.
Whose Justice? Which Rationality?Alasdair MacIntyre - 1988 - University of Notre Dame Press.
The Therapy of Desire.Martha Nussbaum - 1994 - Princeton University Press.

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