IDEAS home Printed from
   My bibliography  Save this article

The new subjective medicine: taking the patient's point of view on health care and health


  • Sullivan, Mark


Calls to respect patient autonomy and produce patient-centered outcomes have recently brought the patient's point of view back into the center of clinical medicine. Bioethics has argued that patient values must be respected in health care decisions. But it has generally not questioned medicine's goals, including its definition of health. For bioethics, health has remained an objective biological fact. However, pressures to improve the cost-effectiveness of medical care have increased interest in the subjective health and quality of life of patients. Perceived health, health-related quality of life, and health-state utilities bring health assessment progressively closer to the patient's perspective. Now even death's harm to patients is qualified by the value patients place on their health state. Medicine's epidemiological transition from acute to chronic disease is thus prompting an epistemological transition from primarily objective to primarily subjective evidence of health and health care effectiveness. Now some of the most important patient outcomes, like patient choices before them, are valid because they are subjective. Pathophysiology is appropriately becoming a means to produce health as it is defined from the patient's point of view. The physicians' job description will be changed to focus on patients' lives rather than patients' bodies. Definitive evaluations of medical effectiveness will occur within patients' lives rather than within doctors' hospitals. This further incorporation of patient subjectivity should carry us well beyond informed consent and the other protections for patient autonomy bequeathed to us by bioethics.

Suggested Citation

  • Sullivan, Mark, 2003. "The new subjective medicine: taking the patient's point of view on health care and health," Social Science & Medicine, Elsevier, vol. 56(7), pages 1595-1604, April.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:7:p:1595-1604

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Miller, Nancy & Weinstein, Marcie, 2007. "Participation and knowledge related to a nursing home admission decision among a working age population," Social Science & Medicine, Elsevier, vol. 64(2), pages 303-313, January.
    2. Finn, Mark & Sarangi, Srikant, 2008. "Quality of life as a mode of governance: NGO talk of HIV 'positive' health in India," Social Science & Medicine, Elsevier, vol. 66(7), pages 1568-1578, April.
    3. Gisquet, Elsa, 2008. "Cerebral implants and Parkinson's disease: A unique form of biographical disruption?," Social Science & Medicine, Elsevier, vol. 67(11), pages 1847-1851, December.
    4. Christen, Regula Nelly & Alder, Judith & Bitzer, Johannes, 2008. "Gender differences in physicians' communicative skills and their influence on patient satisfaction in gynaecological outpatient consultations," Social Science & Medicine, Elsevier, vol. 66(7), pages 1474-1483, April.
    5. Oviedo, Enrique & Fernández, Andrés, 2010. "Information and communication technologies in the health sector: opportunities and challenges for the reduction of inequalities in Latin America and the Caribbean," Políticas Sociales 165, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    6. Thompson, Andrew G.H., 2007. "The meaning of patient involvement and participation in health care consultations: A taxonomy," Social Science & Medicine, Elsevier, vol. 64(6), pages 1297-1310, March.
    7. Eissens van der Laan, M.R. & van Offenbeek, M.A.G. & Broekhuis, H. & Slaets, J.P.J., 2014. "A person-centred segmentation study in elderly care: Towards efficient demand-driven care," Social Science & Medicine, Elsevier, vol. 113(C), pages 68-76.
    8. Lehoux, Pascale & Poland, Blake & Daudelin, Genevieve, 2006. "Focus group research and "the patient's view"," Social Science & Medicine, Elsevier, vol. 63(8), pages 2091-2104, October.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:56:y:2003:i:7:p:1595-1604. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.