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Person-Centred Care: Putting the Organic Horse back in front of the Mechanical Cart

Stephen Tyreman

Abstract


Is person centred care merely a humanitarian addition to good medical practice - considering the person’s personal needs and wishes on top of mending the body? Or is it a truly fundamental essential of good practice in the way that hygiene was in the 19th Century? Is there a compelling (rather than merely desirable) reason for being person-centred?

This chapter defends the claim that the holistic person is primal to understanding human health and healthcare. Human beings are organisms, not mechanisms, and there are fundamental differences between the two. Organisms are essentially whole at all stages of their development, whereas machines are not whole until assembled from component parts.  In addition, organisms are always in transition in response to the ever-changing environment. While these distinctions have been recognised since the ancients, medicine in the modern era has largely focused on body mechanisms for its theory and practice. Dramatic increases in knowledge and technological innovation have led to a focus on the body as a machine and a failure to consider the implications of the organism for human health.

The chapter argues that, in contrast to current thinking, a person is not constituted by the capacity of their genes and molecular mechanisms, etc., but by their unique set of experiences together with a narrative that interprets and gives meaning to them. The role of genes along with other body mechanisms is not so much to provide a blue-print for body growth and development, as a means of responding and adapting to environmental resources and challenges. It is the essence of those responses that forms the core of human experiences in all domains.

Keywords


Machine-as-metaphor, meaning, mechanisms, narratives, organisms, physical-causal framework, process philosophy, uniqueness

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References


Heidegger, M. (1995). The Fundamental Concepts of Metaphysics: World, Finitude, Solitude (W. McNeill & N. Walker, Trans. 2nd edn.). Bloomington and Indianapolis: Indiana University Press.

von Uexküll, J. (2010). A Foray into the Worlds of Animals and Humans (O’Neil, J.D. Trans.). Minneapolis: University of Minnesota Press.

Harrington, A. (1996). Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler. Princeton, New Jersey: Princeton University Press.

Nay R. (2014) Person-Centred Care and Consumer Directed Care Clarity in Communication: Discussion Paper. Available at: https://www2.health.vic.gov.au/ageing-and-aged-care/residential-aged-care/safety-and-quality/strengthening-governance.

Crepaz-Keay, D., Fulford, K.W.M. & van Staden, C.W. (2015). Putting both a person and people first: values-based practice and African Batho Pele as resources for co-production in mental health. In: The Oxford Handbook of Psychiatric Ethics. Sadler, J.Z., van Staden, W. & Fulford, K.W.M., (Eds). Oxford: Oxford University Press.

Dunn, M., Fulford, K.W.M., Herring, J. & Handa, A. (2018). Between the Reasonable and the Particular. Health Care Analysis 27 (2) 110-127.

Yelovich, M‐C. (2016). The patient–physician interaction as a meeting of experts: one solution to the problem of patient nonadherence. Journal of Evaluation Clinical Practice 22 (4) 558‐564.

Loughlin, M., Lewith, G. & Falkenberg, T. (2013). Science, practice and mythology: a definition and examination of the implications of scientism in medicine. Health Care Analysis 21 (2) 130‐145.

Best, M. & Neuhauser, D. (2004). Ignaz Semmelweis and the birth of infection control. BMJ Quality and Safety 13 (3) 233-234.

Nicholson, D.J. (2013). Organisms ≠ Machines. Studies in History and Philosophy of Biological and Biomedical Sciences 44, 669-678.

Sheets-Johnstone, M. (2011). The Primacy of Movement (2nd edn.). Amsterdam/Philadelphia: John Benjamins Publishing Company.

Searle, J. (1983). Intentionality: An Essay in the Philosophy of Mind. Cambridge, Mass.: Cambridge University Press.

Dewey, J. (1981). “Experience and nature”. In: The later works, 1925–1953. Volume 1: 1925, experience and nature, Edited by: Boydston, J.A. 3-326. Carbondale, IL: Southern Illinois University Press.

Wittgenstein, L. (1969). On Certainty. New York: Harper and Row.

Snowden, D. (2002). Complex acts of knowing: paradox and descriptive self-awareness. Journal of Knowledge Management 6 (2) 100-111.

Mercier, P (2008). Night Train to Lisbon. New York: Grove Press

Whitehead, A.N. (1979). Process and Reality (2nd edn.). New York: Macmillan USA.

Sherburne, D.W. (1981). A Key to Whitehead’s Process and Reality. Chicago: University of Chicago Press.

Krüger, H-P. (2010). Persons and Their Bodies: The Körper/Leib Distinction and Helmuth Plessner’s Theories of Ex-centric Positionality and Homo absconditus. Journal of Speculative Philosophy 24 (3) 256-274.

Kazantzakis, N. (2008). Zorba the Greek. London: Faber and Faber.

Pullman, P. (2000). His Dark Materials. New York: Scholastic.




DOI: http://dx.doi.org/10.5750/ejpch.v8i1.1823

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