Question Of Choice

Healthcare systems have denied patients their autonomy for many decades. In recent years, however, patients have increasingly become interested in playing an active part in the treatment decision-making process for their condition. Naturally, this has led to patients reclaiming their autonomy in order to facilitate their desire to exercise their competency and active participation.

Of course, the birth of such a phenomenon is largely owing to the advancement in information technology that has brought about the era of consumer enlightenment. This has led to a gradual change of culture among healthcare professionals with respect to their historical practice of making unilateral treatment decisions without patient involvement. Increasingly, government and private organizations are bombarding patients with information about their condition either through personal contacts, different media or the environment of secondary/primary care using different techniques.

There now seems to be a political will and consensus on the need for more consumer information. In the UK, the Labour Party policy document "A Fresh Start for Health" supports the development of patient autonomy. This means a patient population that is more self-confident, more assertive and more knowledgeable. Furthermore, this document promotes the rights of patients to gain more information about choices of treatment and proposes that patients who are better informed about alternative forms of treatment and who participate in the management of their case are more likely to cooperate in beneficial changes and may contribute to a better prospect for a successful outcome. Access to the right information at the right time is a crucial ingredient of modern healthcare. Across the world there is growing interest in information about health and health services, and to keep the momentum, it is important to develop a culture among healthcare workers that promotes a positive attitude to patients' rights to give and receive information (3). These issues will be examined further in later sections of this chapter.

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Self Help Affirmations

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