Patient empowerment

Patient participation is a trend that arose in answer to perceived physician paternalism. However, only rarely can unchecked physician paternalism be justified, and unlimited patient autonomy would presumably be equally abhorrent.

In recent years the term patient participation has been used in many different contexts. Participatory medicine, health consumerism and patient-centered care. For the latter context, i.e. patient-centered care, a more nuanced definition was proposed in 2009 by the president of the Institute for Healthcare Improvement Donald Berwick: "The experience (to the extent the informed, individual patient desires it) of transparency, individualization, recognition, respect, dignity, and choice in all matters, without exception, related to one’s person, circumstances, and relationships in health care" are concepts closely related to patient participation. In the UK over the course of 2016 two new relevant terms have expanded in usage: Patient and Public Involvement (PPI) ..and Engagement (PPIE) in the sense of the older term Coproduction_(public_services).

Patient participation can be subdivided into the following areas where there seems to be a role for patients and / or their advocates (The term is too generic for this list to be exhaustive. See Kelty et al. for general background ):

This is traditionally understood as a dialogue between patients and physicians in clinical practice. For details, see separate article entitled Shared_decision-making in medicine (SDM). In addition, a newer development likely to affect SDM is listed below as Artificial Intelligence (AI) in healthcare.

Transatlantic examples are given below (see also Health_advocacy).

This includes agenda-setting, clinical guideline development and clinical trial design (see also Health_advocacy).

Workshops in Denmark and Austria have resulted in calls to action to reinforce patients' role in the latter three categories. The Danish workshop recommended the new Toolbox of resources for patient participation from the European Patients' Academy on Therapeutic Innovation (EUPATI). Furthermore the Danish workshop reported that the European Medicines Agency would be "measuring the impact of patient involvement", this being crucial to establishing credibility. And indeed, measurement is provided for in the place cited

In Austria a bibliography inter alia resulted from the most recent event in a workshop series continuing through 2019 entitled "Toward a Shared Culture of Health: Enriching and Charting the Patient-Clinician Relationship held from 10 - 16 Mar, 2017,

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