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Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research

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Abstract

This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.

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Notes

  1. See also, as examples, the following webpages where PCC is framed in rather missionary as well as entrepeneurial contexts: Eric Haider (http://www.personcenteredcare.com), The Person Centered Care Advocate (http://www.personcenteredcareadvocate.org/), Ohio Person-Centered Care Coalition (http://www.centeredcare.org/), Institute for Patient- and Family-Centered Care (http://www.ipfcc.org/) and Foundation for Informed Medical Decision Making (http://www.informedmedicaldecisions.org/).

  2. Several such ideas are presently being developed and tested in projects at the University of Gothenburg Center for Person Centered Care (GPCC).

  3. Lack of consistently and regularly applied standard treatments also threatens making the cost-efficiency instrument itself inapplicable, or at least blunter than it is today, thus making it difficult to apply any sort of cost-efficiency requirement in the prioritarisation of health care resources. A possible remedy may be to develop more sensitive cost-efficiency instruments that relate to a minimally reasonable treatment standard and rate a number of modifications to be found in between this lower level and the best treatment standard. Presumably, such instruments would have to take into account statistics on compliance and adherence.

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Acknowledgment

This work was supported by University of Gothenburg Centre for Person-Centred Care (GPCC), Sweden. GPCC is funded by the Swedish Government’s grant for Strategic Research Areas, Care Sciences [Application to Swedish Research Council nr 2009-1088] and co-funded by University of Gothenburg, Sweden.

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Correspondence to Daniela Cutas.

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Munthe, C., Sandman, L. & Cutas, D. Person Centred Care and Shared Decision Making: Implications for Ethics, Public Health and Research. Health Care Anal 20, 231–249 (2012). https://doi.org/10.1007/s10728-011-0183-y

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