The Choice Agenda: Patient or Consumer?
*Call For Papers*
It has become trite to observe that autonomy has, in recent decades, been the dominant principle in medical ethics and medical law. Indeed, the
‘doctor knows best’ paternalism of previous generations, with its inherent class/sex/cultural bias, is something for which few of us would, presumably, grow nostalgic. Yet among
close observers of the healthcare system, a concern has begun to grow that beneath the rhetorical commitment to ‘informed consent’ and ‘patient choice’ lurks another
agenda, that sees patients not only as autonomous, ‘empowered’ agents (Department of Health, Choice Matters, 2007) whose choices and values are worthy of respect, but
predominantly as consumers in an increasingly ‘liberalised’ healthcare marketplace. (See, for instance, Harrington, ‘Law, globalisation and the NHS’, Capital &
Class, Summer 2007)
This ‘choice’ agenda, it has been argued, has resulted in vast sums of state money being lavished on initiatives such as NHS Direct and ‘choose and book’, which are
responsive to the demands of, and in practice used by, a relatively affluent, educated and assertive minority. (Pollock, NHS plc, 2004) Perhaps even more alarming is the suggestion that
casting patients as ‘mutually competitive consumers’ risks undermining the ‘shared popular understanding of solidarity ... that made the NHS possible in the first
place’. (Tudor Hart, The political economy of health care, 2006)
The stream, then, will consider where the ‘patient choice’ agenda is leading, and what prospects it poses for the future of the NHS. Is it possible - and if so, how
is it possible - to safeguard the gains made in terms of the dignity and autonomy of patients, without surrendering to the marketisation of healthcare? What experiences have other
countries had with such markets - or what alternative strategies have they found?
Stream Organiser:
Colin Gavaghan
Send titles and abstracts to the organising committee by 15 June:
clc@lbss.gla.ac.uk