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Clin Ethics 2009;4:152-155
doi:10.1258/ce.2009.009021
© 2009 Royal Society of Medicine Press

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Strengths and limitations of considering patients as ethics ‘actors’ equal to doctors: reflections on the patients' position in a French clinical ethics consultation setting

Eirini Rari   and Véronique Fournier 

Centre d'éthique clinique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France

E-mail: eirini.rari{at}cch.aphp.fr

The Clinical ethics centre in Paris offers its services equally to doctors and patients/proxies. Its primary goal is to re-equilibrate doctor–patient roles through giving greater voice to patients individually in medical decisions. Patients are present at virtually all levels, initiating consults, providing their point of view and receiving feedback. The implications of patients' involvement are threefold. At an operational level, decision-making is facilitated by repositioning the debate on ethical grounds and introducing a dynamic of decisional partnership, although contact with patients can make it difficult to deny their demands and set the limits of our role. Ethically, it reinforces patients' autonomy and grants them a place of veritable ethics ‘actors’, with the danger that this may become excessively autonomy oriented. Finally, at a collective level, the programme fulfils its political purpose in promoting patients' rights and the ideal of démocratie sanitaire, but complicates balancing individual demands with collective values.


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This article has been cited by other articles:


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Clin EthicsHome page
A. J Newson, G. Neitzke, and S. Reiter-Theil
The role of patients in European clinical ethics consultation
Clin Ethics, September 1, 2009; 4(3): 109 - 110.
[Full Text] [PDF]


Home page
Clin EthicsHome page
V. Fournier, E. Rari, R. Forde, G. Neitzke, R. Pegoraro, and A. J Newson
Clinical ethics consultation in Europe: a comparative and ethical review of the role of patients
Clin Ethics, September 1, 2009; 4(3): 131 - 138.
[Abstract] [Full Text] [PDF]



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