ArticlePhilosophy, ethics, and humanities in medicine : PEHM2018
Patients and agents - or why we need a different narrative: a philosophical analysis.
Article in Philosophy, ethics, and humanities in medicine : PEHM, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A multi-systemic ethical dilemma model in hemodialysis patients: a qualitative study.BMC medical ethics · 2026Article
- Development and Validation of Narrative Competence Scale for Medical Students.Perspectives on medical education · 2026Article
- The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem.Science and engineering ethics · 2020Article
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
backgroundThe success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness.
methodsPhilosophical analysis of background assumptions of the current paradigmatic model.
resultsWhile these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of "the patient". This narrative is conceptually linked to the developing philosophy of person-centred care.
conclusionsIf patients are seen also as "agents" this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients' motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from "treating" and "battling" diseases and their purported "mechanisms" to understanding complex contributing factors and their interplay.
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Registered trials
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