Patient-centred care through a broader lens: Supporting patient autonomy alongside moral deliberation

Abstract

Patient-centred care (PCC) is an essential component of high-quality healthcare and shared decision-making is its cornerstone. Yet, integrating the principles of PCC into healthcare practice is not always straightforward and shared decision-making can be complicated and ethically demanding. While ethicists and academics routinely debate moral aspects of clinical care, such discussion among clinicians is less overt. In this paper, we use Emmanuel et al.'s deliberative model to provide a practical framework for considering ethical aspects of PCC and shared decision-making. The model encourages us to appreciate PCC through a broader lens and consider patient autonomy alongside other moral obligations such as justice and the equitable distribution of finite resources. The model can be used by healthcare providers, patients and caregivers to facilitate dialogue and moral deliberation regarding the merit of their preferences and values; in this way, individualised care can be delivered without compromising other important ethical obligations.

Keywords: moral deliberation; patient autonomy; patient-centred care; shared decision-making.