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Chronicity: a key concept to deliver ethically driven chronic care
  1. Francisca Stutzin Donoso
  1. Public Health and Primary Care, University of Cambridge, Cambridge CB2 1TN, UK
  1. Correspondence to Dr Francisca Stutzin Donoso, Public Health and Primary Care, University of Cambridge, Cambridge CB2 1TN, UK; fsd26{at}

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Chronic diseases are the main disease burden worldwide, leading to premature deaths and poor individual and population health outcomes. Although modern medicine has made significant progress in developing effective treatments, only around 50% of people follow long-term treatment recommendations in high-income countries and presumably even less in low-income and middle-income countries.1 Health outcomes for chronic diseases follow a social gradient across socioeconomic groups, suggesting that the 50% adherence rate distributes unequally across social groups, affecting those who live in disadvantage the most despite universal health coverage.2

Bioethicists have largely ignored inequalities that arise from differences in adherence to long-term treatments and the importance of the ethical dimension of chronicity for clinical practice. As I discuss in detail elsewhere, the concept of ‘chronic disease’ lacks a successful and agreed definition, failing to be structured in a traditional way and allowing for a disjunctive group of diseases to fall under the concept.3 Still, the main element that helps distinguish ‘chronic diseases’ from all other diseases is their long duration, so the noun chronicity can help demarcate and identify the nature of ‘chronic disease’.

Drawing on conceptual analysis and phenomenological research on illness that highlight the tension between the cyclical and static elements of chronic disease, I have argued that chronicity has a phenomenological sense beyond its …

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  • Contributors I am the sole author of this column.

  • Funding This research is funded by the National Research and Development Agency (ANID) of the Chilean Government, programme Becas-Chile Scholarship for PhD studies.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Further details about this study are available on request.

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