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Patient empowerment and control: a psychological discourse in the service of medicine

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  • Salmon, Peter
  • Hall, George M

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.

Suggested Citation

  • Salmon, Peter & Hall, George M, 2003. "Patient empowerment and control: a psychological discourse in the service of medicine," Social Science & Medicine, Elsevier, vol. 57(10), pages 1969-1980, November.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:10:p:1969-1980
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    Citations

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    Cited by:

    1. Marie Falahee & Gwenda Simons & Karim Raza & Rebecca J. Stack, 2018. "Healthcare professionals’ perceptions of risk in the context of genetic testing for the prediction of chronic disease: a qualitative metasynthesis," Journal of Risk Research, Taylor & Francis Journals, vol. 21(2), pages 129-166, February.
    2. O'Cathain, Alicia & Goode, Jackie & Luff, Donna & Strangleman, Tim & Hanlon, Gerard & Greatbatch, David, 2005. "Does NHS Direct empower patients?," Social Science & Medicine, Elsevier, vol. 61(8), pages 1761-1771, October.
    3. Aujoulat, Isabelle & Marcolongo, Renzo & Bonadiman, Leopoldo & Deccache, Alain, 2008. "Reconsidering patient empowerment in chronic illness: A critique of models of self-efficacy and bodily control," Social Science & Medicine, Elsevier, vol. 66(5), pages 1228-1239, March.
    4. Kinderman, Peter & Setzu, Erika & Lobban, Fiona & Salmon, Peter, 2006. "Illness beliefs in schizophrenia," Social Science & Medicine, Elsevier, vol. 63(7), pages 1900-1911, October.
    5. Lucas, Henry, 2015. "New technology and illness self-management: Potential relevance for resource-poor populations in Asia," Social Science & Medicine, Elsevier, vol. 145(C), pages 145-153.
    6. Marit Solbjør & Marit By Rise & Heidi Westerlund & Aslak Steinsbekk, 2013. "Patient participation in mental healthcare: When is it difficult? A qualitative study of users and providers in a mental health hospital in Norway," International Journal of Social Psychiatry, , vol. 59(2), pages 107-113, March.
    7. Chinn, Deborah, 2011. "Critical health literacy: A review and critical analysis," Social Science & Medicine, Elsevier, vol. 73(1), pages 60-67, July.
    8. Thille, Patricia & Ward, Natalie & Russell, Grant, 2014. "Self-management support in primary care: Enactments, disruptions, and conversational consequences," Social Science & Medicine, Elsevier, vol. 108(C), pages 97-105.
    9. Lemire, Marc & Sicotte, Claude & Paré, Guy, 2008. "Internet use and the logics of personal empowerment in health," Health Policy, Elsevier, vol. 88(1), pages 130-140, October.
    10. Mendick, Nicola & Young, Bridget & Holcombe, Christopher & Salmon, Peter, 2010. "The ethics of responsibility and ownership in decision-making about treatment for breast cancer: Triangulation of consultation with patient and surgeon perspectives," Social Science & Medicine, Elsevier, vol. 70(12), pages 1904-1911, June.

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