[Dialogues on risks and health resources in general practice].
The healing and preventive forces related to individuals' health resources and self-assessed knowledge have hitherto been underestimated in medicine. In this article, we draw attention to ethical and epistemological challenges in relation to values, communication, knowledge, and autonomy that are embedded in the prevailing risk-oriented epidemiology. We have developed a theoretical model for a patient-centered, salutogenetic approach with the aim of a better balance between health resources and risk factors. We briefly present results of dialogues in the general practice consultation based on key questions about self-assessed health resources. We discuss pitfalls related to causality, group-based probabilities, medicalization, and informed consent, focusing on the clinical encounter with the individual patient. By introducing a salutogenetic perspective, we hope to shift attention towards the patient's resources and strengths. Communication can mediate oppression as well as empowerment.
Hollnagel
Hanne
H
Central forskningsenhed for almen praksis, afdeling for almen medicin, Københavns Universitet, Institut for Folkesundhedsvidenskab. Hanne.Hollnagel@gpract.ku.dk
Malterud
Kirsti
K
D003142:Communication; D005194:Family Practice / Q000941:ethics; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000941:ethics; D006295:Health Resources / Q000941:ethics; D006801:Humans; D008962:Models, Theoretical; D018802:Patient-Centered Care / Q000941:ethics; D010817:Physician-Patient Relations / Q000941:ethics; D011209:Power, Psychological; D018570:Risk Assessment; D012307:Risk Factors; D012647:Self-Assessment