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Healthy Skepticism Library item: 5376

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Salmon P, Hall GM.
Patient empowerment and control: a psychological discourse in the service of medicine.
Soc Sci Med 2003 Nov 01; 57:(10):1969-80
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-4899V1S-4&_coverDate=11%2F30%2F2003&_alid=421169285&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=5925&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0108299694b7ad851b9ec164f0cf893a


Abstract:

The discourse of the patient as an active agent in managing illness and health care has become very important in medicine. It is seen in the significance attached to patient empowerment and participation, and in the burgeoning research into patients’ coping with illness. The discourse cannot be fully understood from within conventional scientific frameworks because it is part of those frameworks. Instead, its current prominence can be understood by examining how it meets the needs of those who use it. Specifically, it has combined with earlier discourses of disease in a way that allows clinicians to withdraw from responsibility for areas of patient need that are problematic for medicine, such as unexplained symptoms, chronic disease and pain. This view is supported by evidence about how the discourse of patient as agent has been used in clinical consultation to constrain doctors’ responsibility for patients’ suffering. This discourse and other ways in which doctors and patients influence the boundaries of medical responsibility should be subjects for, rather than constraints on, empirical research.

Keywords:
Adaptation, Psychological Attitude of Health Personnel* Communication Health Services Research Humans Patient Participation/psychology* Personal Autonomy Physician-Patient Relations* Power (Psychology) Psychophysiology Social Responsibility Sociology, Medical* Stress, Psychological/etiology Stress, Psychological/therapy

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909