This article explores ethical aspects of using open argumentation in person-centered care (PCC), where health professionals (HPs)
openly criticize or contradict factual claims, assumptions, preferences, or value commitments of patients. We argue that such
disputing may be claimed to have an important place in advanced versions of PCC, but that it actualizes
important clinical ethical aspects of doing such disputation well. This may prompt caution in the implementation of PCC, but also
inspire educational and organizational reform. We also probe the notion of openly disputing with patients when PCC is applied in
less standard settings (where it is nevertheless advocated), using the cases of children, psychiatry, and public health
interventions, such as antibiotic stewardship programs, as examples. These contexts offer new reasons for why PCC may or should
include open disputing with patients, but also introduce new ethical complications. Some of these may transform either to
arguments against PCC implementation in these areas, or to a more open view of the extent a HP may seek to dominate patients in a
PCC setting. We are especially skeptical of the meaningfulness of applying advanced PCC in areas of psychiatry with high levels of
compulsory elements, such as forensic psychiatric detention.
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Cited by (6)
Cited by six other publications
Akkermans, Aranka, Sanne Prins, Amber S. Spijkers, Jean Wagemans, Nanon H. M. Labrie, Dick L. Willems, Marcus J. Schultz, Thomas G. V. Cherpanath, Job B. M. van Woensel, Marc van Heerde, Anton H. van Kaam, Moniek van de Loo, Anne Stiggelbout, Ellen M. A. Smets & Mirjam A. de Vos
2023. Argumentation in end-of-life conversations with families in Dutch intensive care units: a qualitative observational study. Intensive Care Medicine 49:4 ► pp. 421 ff.
El-Alti, Leila
2023. Shared Decision Making in Psychiatry: Dissolving the Responsibility Problem. Health Care Analysis 31:2 ► pp. 65 ff.
El-Alti, Leila, Lars Sandman, Christian Munthe & Tella Lantta
2022. Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care. PLOS ONE 17:9 ► pp. e0275205 ff.
Söderberg, Andreas, Märta Wallinius, Christian Munthe, Mikael Rask & Ulrica Hörberg
2022. Patients’ Experiences of Participation in High-Security, Forensic Psychiatric Care. Issues in Mental Health Nursing 43:7 ► pp. 683 ff.
2020. An Interview Study of Professional Carers’ Experiences of Supporting Patient Participation in a Maximum Security Forensic Psychiatric Setting. Issues in Mental Health Nursing 41:3 ► pp. 201 ff.
Westgård, Theresa, Katarina Wilhelmson, Synneve Dahlin-Ivanoff & Isabelle Ottenvall Hammar
2019. Feeling Respected as a Person: a Qualitative Analysis of Frail Older People’s Experiences on an Acute Geriatric Ward Practicing a Comprehensive Geriatric Assessment. Geriatrics 4:1 ► pp. 16 ff.
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