“I like to be an informed person but…” negotiating responsibility for treatment decisions in cancer care

Sinding, Christina; Hudak, Pamela L.; Wiernikowski, Jennifer; Aronson, Jane; Miller, Pat; Gould, Judith; Fitzpatrick‐Lewis, Donna

doi:10.1016/j.socscimed.2010.06.005

Cited by 76 publications

(64 citation statements)

References 30 publications

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“…Yet the typical presentation of treatments in many cancer clinics involves outlining risks and benefits and encouraging patients to decide. The mismatch between contemporary treatment decisions practices and the patient's expectation of unequivocal direction from her physician seems to have played a role in this patient's (lack of) treatment [122]. Again, then, the value of respecting patient preferences for treatments and care must be tempered by a critical understanding of the social determinants of these preferences.…”

Section: Conceptual Challenges and Opportunitiesmentioning

confidence: 99%

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Sinding

Warren

Fitzpatrick‐Lewis

et al. 2014

Support Care Cancer

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The paper reviews published studies focused on disparities in receipt of cancer treatments and supportive care services in countries where cancer care is free at the point of access. We map these studies in terms of the equity stratifiers they examined, the countries in which they took place, and the care settings and cancer populations they investigated. Based on this map, we reflect on patterns of scholarly attention to equity and disparity in cancer care. We then consider conceptual challenges and opportunities in the field, including how treatment disparities are defined, how equity stratifiers are defined and conceptualized and how disparities are explained, with special attention to the challenge of psychosocial explanations.

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Section: Conceptual Challenges and Opportunitiesmentioning

confidence: 99%

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Sinding

Warren

Fitzpatrick‐Lewis

et al. 2014

Support Care Cancer

Self Cite

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“…In other words, a patient’s preferences with respect to involvement in medical decision-making may vary for different contexts or disease/life phases (De Haes 2006; Holmström and Röing 2010; Sinding et al 2010):It is neither an ethical lapse nor a character flaw for a patient to prefer to have the doctor decide what to do. Nor is it irrational for a patient to want to be in control of decisions, with the physician or physicians acting as advisors and guides.…”

Section: Discourse 3: Being Responsivementioning

confidence: 99%

Differences that matter: developing critical insights into discourses of patient-centeredness

Pluut

2016

Med Health Care and Philos

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Patient-centeredness can be considered a popular, and at the same time “fuzzy”, concept. Scientists have proposed different definitions and models. The present article studies scientific publications that discuss the meaning of patient-centeredness to identify different “discourses” of patient-centeredness. Three discourses are presented; the first is labelled as “caring for patients”, the second as “empowering patients” and the third as “being responsive”. Each of these discourses has different things to say about (a) the why of patient-centeredness; (b) the patient’s identity; (c) the role of the healthcare professional; (d) responsibilities for medical decision-making, and (e) the role of health information. This article compares and contrasts the discourses in ways that allow us to see differences that matter for practitioners in healthcare. On the basis of a relational constructionist philosophy, it is argued that discursive diversity is both an inevitable and a potentially valuable aspect of conversations in healthcare. We are therefore invited to center the challenge of dealing with diversity in productive ways. This article ends with a discussion of the practical implications of the discourse analysis for projects that aim to make healthcare more patient-centered. Debates on patient-centered “Health Information Exchange” are used to explain the need for a recognition of different discourses of patient-centeredness and a reflexive stance towards them.

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“…Salander and Moynihan (2010, 119) show how the 'instrumental intervention' of 'information giving' that dominates the new approach to cancer care fails to address the fact that 'healing' is a 'contextual experience '. Salander and Henriksson (2005) argue that the delivery of information may be less important to patients than expressions of care, and Sinding et al (2010Sinding et al ( , 1099 show how women's attempts to 'deflect and reframe' responsibility for decision-making and to elicit physicians' opinions in the context of breast cancer, can be read as resistance to the rational information paradigm that dominates the current organisation of cancer care. In a study of information aimed at encouraging self-care in the field of 'healthy living', Author et al (2011) draw explicitly on Mol's logics of choice and care (Mol 2008) to make sense of the resistance to healthy living messaging they encountered amongst participants.…”

Section: The Informatisation Of Carementioning

confidence: 99%

Inform with Care: Ethics and Information in Care for People with Dementia

Barnes

Henwood²

2015

Ethics and Social Welfare

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Good care is often positioned as a natural by-product of the widespread availability of good information ('inform to care'). This paper contests this association through empirical investigation of the information-care relationship in the context of dementia care. It combines critiques of the 'informatisation' of care with insights from the epistemological dimension of care ethics to argue that information is better understood as 'situated knowledge' and that the relational practices of care involve the mobilisation and negotiation of different types of knowledge that are specific to caring relationships and contexts. The argument is illustrated through the three cases of caring relationships taken from a qualitative evaluation of an information and support course for carers of people with dementia. These cases highlight the specificity of caring relationships and the very different consequences of introducing new forms of knowledge into each relationship and provide evidence for the need for a paradigm shift where the idea of informing to care is replaced by a process of informing with care. In the former, information is understood as separate and outside of care, while nevertheless acting upon it to produce care; in the latter, information is understood as inextricably linked to care (with care) but not in any predetermined or uni-directional sense. The paper identifies key interlinked components of the 'inform with care' approach derived from the cases discussed.

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“I like to be an informed person but…” negotiating responsibility for treatment decisions in cancer care

Cited by 76 publications

References 30 publications

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Research in cancer care disparities in countries with universal healthcare: mapping the field and its conceptual contours

Differences that matter: developing critical insights into discourses of patient-centeredness

Inform with Care: Ethics and Information in Care for People with Dementia

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