Empowering Patients Is Good Medical Care

摘要

Walter and Ross rightfully argue that healthcare providers need to employ a less authoritarian, more empowering approach if they want to support patients' behavioral changes. They show how motivational interviewing (MI), informed by self-determination theory, engages patients and thus may inspire enduring changes. They ground these interventions in an important, new model of relational autonomy, emphasizing the patient's self-respect and self-cohesion as well as self-determination, and they show how patient-provider interactions influence these three aspects of autonomy. It may be surprising then, that in the first part of this essay, I argue that it is problematic for them to ground their empowerment model in the ethical obligation to respect patient autonomy. In the second part of this essay, I offer an alternative justification for their important practical recommendations, arguing that the obligation to empower patients derives not from the patient's autonomy rights, but from the provider's foundational responsibility to promote the patient's health and well-being.