Why is choice important in care

Something may look nice, but it may cost you in the end while another choice may seem bad at first, but it may impact you positively. No matter what you choose to, know that there is something attached to it. Not deciding is deciding. Are there times you find yourself pushing something aside instead of dealing with it? Well, you may think that you are saving yourself the trouble, but, the truth is not deciding is also a choice in itself.

Delaying something does not take it away. So it is better you decide irrespective of what you think or feel. A good Choice will help you to head in the right direction. When we make the right decisions, our lives start heading in the right direction. Allyson Pollock and others. Link to original Lancet article. The choices patients make. Patients may vary in their desire for involvement in decision making in consultations.

Doctors need the skills, knowledge of their patients, and the time to determine on which occasions, with which illnesses, and at which level their patients wish to be involved in decision making. Do patients wish to be involved in decision making in the consultation? A cross sectional survey with video vignettes. The Department of Health Consultation on patient choice. Patient choice: How to haggle with your doctor, lessons from America.

Shared Mind: Communication, Decision making and autonomy in serious illness Brilliant article exploring the issues I have discussed in more detail. Shared decision making. Having more choices, on the surface, appears to be a positive development; however it hides an underlying problem: faced with too many choices, consumers have trouble making optimal choices, and thus as a result can be indecisive, unhappy, and even refrain from making the choice. In a society geared towards the individual, and dominated by consumerism and celebrity, we are constantly encouraged to choose a better life for ourselves.

The weight of each choice and the super-abundance of options can cause crippling anxiety and we defer to others to make the right choices for us. When we do get what we want, fulfilment is swiftly replaced by dissatisfaction and desire for a better option. How do patients choose physicians? The impact of patient choice of provider on equity.

Patient choice and the organisation and delivery of health services. Patient choice and equity in the British National Health Service. The claim for patient choice and equity. How patient choice can work, Ian Greener. Hposital outcome data is too flawed for patients to use it to make choices. Academic Health Economists blog. Do patients want a choice and does it work? Patient choice how patients choose and providers respond, Kings Fund.

Increased inequity is a risk unless the choice policy includes a means of targeting disadvantaged groups, including older people, those who are less educated, those on low incomes and ethnic minority groups, to prevent such exclusion Health Link, ; Which?

Great post. In the social care sector, these are the people who have been left with second rate care while those who can choose to have personal budgets for care can pick the higher quality and more individualised services. These reforms are poisonous particularly to the more vulnerable in society.

Recently I had to kidnap my 90 year old mother from a ward at the local Foundation Hospital; she had fractured her hip; no-one would give me a time or even date for her operation, and I knew stats.

Thanks for this Anne Marie, this is exactly what I was getting at. Oh good: Epstein visitied Cardiff earlier this year. I was very impressed with his presentation and wanted to tell the world then!

The worrying thing is that many people will want metrics before they believe that this is true. We just have to get more and more people to read accounts just your blog and this paper and hope that it clicks with them.

Thanks for this. Those who want to engineer ever more competition in to the system have somewhat won the discursive high ground by entangling choice and quality with competition — thanks for your contribution to the resistance.

Patient choice so much depends on the imagination and energy of the Doctor, the patient and their interaction. It must also be remembered that ill people do not have necessarily have much energy. So, this brings us to the question of, is there a special moral duty and obligation for health professionals to always offer a choice to patients? Or, are there situations where some degree of limited choice may be justifiable, in order to promote the principles of beneficence, non-maleficence and justice?

Autonomy has emerged as one of the most frequently referenced concepts in recent healthcare practice. Choice is tied to the notion of individual autonomy or freedom, a concept that has emerged largely in ethical theories of the good. For example, regarding any treatment offered to patients, it is believed that giving them choices will not just enhance their autonomy but also better inform them about their health conditions and the available treatments 1.

Arguably, there is a fundamental obligation to ensure that patients have the right to choose as well as the right to accept or to decline information 2. Furthermore, Beauchamp and Childress contend that, in some cases, health professionals are obliged to increase the options available to patients, whereby many autonomous actions could not occur without the health professionals and health organisation cooperating to make these options available.

At the same time, the ability to exercise choice is highly valued in many cultures as an expression of individual identity and autonomy. Health care practice encompasses situations in which choices are given and decisions are made, offering frequent opportunities for patients to exercise choice and for practitioners to respect these choices. Nonetheless, respect for autonomy is not an absolute principle within healthcare in general.

First, we need to know that respect for autonomy has only prima facie standing and competing moral considerations can sometimes override it. For example, if our choices jeopardise public health, potentially harm others, or require a scarce resource for which no funds are available, others can justifiably curb our exercising of autonomy.

It is further postulated that, to be genuinely autonomous, we are required to take seriously the social implications of our choices. Whilst there may be occasions when we feel that others do not determine our choices and our choices cannot benefit from discussion with them, this in fact happens very seldom. Of course, it is possible for a person alone to come to a valid moral choice. But placing too much emphasis on the promotion of individual patient choice, particularly when such choices are actually made alone, carries the risk that we might forget either the interests of others or the wider public interest 3.

The most prominent example is that of vaccine safety. Increasing doubts about vaccination appear to stem from conflicting scientific evidence over possible minor side effects, and yet it is highly effective.

A qualitative study reports that Dutch parents refused all or some of the vaccinations in the National Immunisation Program. Other studies indicate that doubts surrounding vaccine safety have resulted in a drop in the number of children being vaccinated and in an increase in outbreaks of measles.

Hence, it has been asserted that providing more choice is likely to lead to lower levels of protection and more infections. In other words, when parents decide not to have their children vaccinated, further harm is potentially possible.

The Institute of Medicine of the National Academies 5 reported that some parents appears to dismiss the well-documented benefits of vaccines and fear potential side effects which lead them not vaccinating their children. In a recent review, it was reported the association between vaccine delay or refusal, and the epidemiology of measles. The study shows that substantial proportion of the measles cases in the United States among individuals who were unvaccinated 6.

In reality, healthcare systems cannot provide everything that each individual patient could want. Arguably, it is possible to act nonmaleficently towards all people at all times, but it is generally not possible to act beneficently towards all people.

Failing to act nonmaleficently toward a party is prima facie immoral, but failing to act beneficently toward a party is very often not immoral 2. Health professionals have no obligation to perform beyond or contradictorily to the goals of medicine even when patients request that they do so. Hence, patients have no right to demand that health professionals provide medical care that is contraindicated, for instance, unnecessary surgery or unorthodox treatments such as odd drug regimens, and should not demand that health professionals do anything illegal or unethical 7.

In practice, there are three main reasons why a patient may be refused his or her treatment of choice. First of all, the doctor regards the treatment as worse than no treatment at all, and doctors are not obliged to give treatments which they think will be detrimental to their patients; secondly, what the patient wants is futile, that is, the treatment is ineffective; and thirdly, what the patient wants, whilst effective for him or her, is not cost-effective for the health service or the opposite situation may hold.

Based on the third reason, let us suppose that there is a new and expensive drug for a particular condition. Whilst the expensive treatment may be effective, it may not be cost-effective.

The cost, for example, per year of life saved, may far surpass what the health service can generally afford.

The health authority may quite reasonably decide not to purchase this drug at all or to only do so for a specified group of patients for whom the drug is more cost-effective 8. Are you happy with your current lifestyle and would prefer to age in place? Healthcare decisions should be made sooner rather than later and should apply to all aspects of your life.

If aging in place sounds interesting to you, here are a few considerations to help you make a decision about what your future might look like:. To make the process less daunting, start by looking at your current physical environment and how to adapt it as you age. You can manage fine at home for now, but what happens once it gets tricker to climb stairs or get in the shower? Once adult children have flown the coop, many retirees choose to downsize.

You might be tempted to move to the city to be closer to public transportation, grocery shopping, recreational activities, and proximity to essential health services like walk-in clinics and hospitals. And cities are taking note.

Right now, over cities in 39 countries have committed to promoting healthy active ageing and improving the quality of life for people over 60 in cities and communities. Of course there are elder care alternatives to aging at home—for example moving in with adult children or into an assisted living facility— but most options sacrifice what seniors value most: their independence. So how can seniors facing the realities of aging continue to live life to the fullest while maintaining their independence?

One option is senior care services, which provide at-home assistance that helps elders stay in their home for longer and live easier and more fulfilling lives. There are also various levels of elder care that can be tailored to meet your individual needs.