Evidence-based Medicine and Patient-centered Care: Cross-Disciplinary Challenges and Healthcare Information Technology-enabled Solutions

Raman, Roopa

doi:10.5750/ijpcm.v1i2.69

Cited by 7 publications

(6 citation statements)

References 45 publications

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“…Pioneers have kick-started person-centered medicine in a really impressive way, challenging established discourses such as EBM with energy and promise [1,2,[59][60][61][62][63]. The promises have included a turn to 'the philosophical understanding of personhood' [2].…”

Section: Resultsmentioning

confidence: 99%

“…If indeed EBM has diminished the personal and the humane in medical practice, PCM seeks to restore them. It defines itself as an amalgam of EBM and patient-centered care [1], capturing the undoubted good of both systems, but also bringing something new to medical education and practice -the concept of the person. But is PCM more than another portmanteau term -like EBM, patient-centered care (PCC), narrative-based medicine, values-based medicine (VBM) -that will attract enthusiasm for a time and then also lose its drawing power?…”

Section: Introductionmentioning

confidence: 99%

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Theorising personhood: for better or for worse

Little¹

2014

EJPCH

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Person-centered medicine is emerging as one of the most formidable critiques of evidence-based medicine. One of its claims to priority over patient-centered care, humane medicine, narrative-based medicine and values-based medicine is its attention to the philosophy of personhood. While it defines personhood in widely accepted terms, using adjectives employed by Cassell, such as ‘embodied, purposeful, thinking, feeling, emotional, reflective, relational’, it offers no examination of the numerous debates and disagreements about personhood. In particular, it has not so far explored the tension that exists between the neo-Lockean account of persistent psychological attributes, such as intention, cognition and rationality and the ‘animalistic’ account that ascribes personhood to human existence, to the human body and brain. Nor has it examined the significance of personhood as an emergent property of human beings imbedded in cultures and societies. Medical ontology is basically realist and its epistemology empiricist. Person-centered medicine faces the task of translating a contested, emergent concept into something realistic and empirically examinable, if it is to persist and have pedagogical purchase. Schectman’s ‘person-life view’ may provide a starting point for conceptualisation and teaching and respect is a relationship that underpins an understanding of personhood, but other guidelines will be needed. Some relevant suggestions are made in this article.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Theorising personhood: for better or for worse

Little¹

2014

EJPCH

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“…Despite considerable promise, the pursuit of patient-centred medicine faces special challenges stemming from the cross-disciplinary nature of decision-making. Unfortunately, these challenges have thus far remained underexplored 12. While EBM greatly improved the quality of care and extended life expectancy of the global population over the course of the 20th century, much can still be done to improve the quality of healthcare by making it more patient centred as we continue our journey through the 21st century (figure 3).…”

Section: Ghost Of the Present: Evidence-based Medicine And The Birth mentioning

confidence: 99%

Not a Humbug: the evolution of patient-centred medical decision-making

et al. 2015

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“…Humane medicine seems to have come and gone as the name for a discourse [48][49][50]. Patient-centered care is still active [51][52][53][54][55], whereas narrative medicine seems to be declining [56-60]. Epstein's mindful practice remains influential [61,62].…”

Section: Humanising Discourse In Medicinementioning

confidence: 99%

The precarious future of the discourse of person-centered medicine

Little

2014

EJPCH

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Discourses are more than just patterns of words. For discourse communities, they express ideologies and provide meanings that can be translated into action. They are vehicles for reform when they thrive. The discourse of person-centered medicine has had a vigorous start, with identifiable leaders, a vocabulary which has situated meanings, institutions such as meetings, letterheads and a Society and a group of adherents that constitute a discourse community. For a discourse to thrive, its founding problematic has to be perceived as 'real' by its target audience -in this case, presumably, healthcare workers. Real in this sense can be defined as something perceived to have an influence on foundational values, for better or for worse. It is not yet clear that the discourse of person-centered medicine has convinced its target audience of the 'crisis of knowledge, care, compassion and costs' that it invokes to justify its proposed paradigm shift. In order to make it thrive, those who drive the discourse will need to 'realise' both the crisis it addresses and the outcomes it may achieve.

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Evidence-based Medicine and Patient-centered Care: Cross-Disciplinary Challenges and Healthcare Information Technology-enabled Solutions

Cited by 7 publications

References 45 publications

Theorising personhood: for better or for worse

Theorising personhood: for better or for worse

Not a Humbug: the evolution of patient-centred medical decision-making

The precarious future of the discourse of person-centered medicine

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