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Adherence, shared decision-making and patient autonomy
University of Borås, School of Health Science.
2012 (English)In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 15, no 2, p. 115-127Article in journal (Refereed) Published
Abstract [en]

In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What this implies in terms of the importance that we have reason to attach to (non-)adherence and how has, however, not been explained. In this article, we explore the relationship between different forms of shared decision-making, patient autonomy and adherence. Distinguishing between dynamically and statically framed adherence we show how the version of shared decision-making advocated will have consequences for whether one should be interested in a dynamically or statically framed adherence and in what way patient adherence should be assessed. In contrast to the former compliance paradigm (where non-compliance was necessarily seen as a problem), using observations about (non-)adherence to assess the success of health care decision making and professional-patient interaction turns out to be a much less straightforward matter.

Place, publisher, year, edition, pages
Springer Verlag , 2012. Vol. 15, no 2, p. 115-127
Keywords [en]
adherence, patient autonomy, shared decision-making, compliance, patient best interest, Person centred care and shared decision-making
National Category
Nursing Philosophy
Research subject
Integrated Caring Science
Identifiers
URN: urn:nbn:se:hb:diva-3132DOI: 10.1007/s11019-011-9336-xISI: 000302380800003PubMedID: 21678125Local ID: 2320/8347OAI: oai:DiVA.org:hb-3132DiVA, id: diva2:871228
Note

Sponsorship:

Centre for person centred care at Gothenburg University

Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-10-25Bibliographically approved

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Publisher's full textPubMedhttp://gup.ub.gu.se/records/fulltext/141966.pdf

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Sandman, Lars

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CiteExportLink to record
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Citation style
  • apa
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