Acceptance, Universal Patient Acceptance, and Access to Care An Update

Abstract

There is an unnoticed step that occurs before a person becomes a patient, that is, every prospective patient must first express his or her need for care to a health professional who responds by describing how the patient might access that care. When the health professional accepts the patient as someone to talk with at the outset, this is termed “acceptance.” Acceptance has been defined as the hidden ethic and core value underlying the applied ethical tool of universal patient acceptance (UPA). Acceptance impacts access to care. Published reactions to acceptance and UPA have so far ranged from thoughtful and constructive, to emotionalized and reactive. As the practical applications of acceptance and UPA are discussed in national forums on access to care, some general trends have emerged. This paper is a status update on UPA and speaks to those proposals and recommendations. The ethical basis of UPA is expanded upon, and the attempt is made to more effectively operationalize the concept and further justify its relevance to the allied-health professions. A clearly articulated notion of acceptance is needed to protect professional conscience from secular interests of patients. It is only after broader multi-disciplinary review and debate, however, that UPA can become less hidden or presupposed, and actually find expression in the ethics codes and training curricula of all the health professions. Once expressed within these professional forums, it will likely gain more relevance in the critical evaluations of acceptance as it is more broadly used in the conversations of economics, politics, and secular (non-professional) society.