title: Governing the ethical consumer: identity, choice and the primary care medical encounter.
abstract: Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertaken by individuals in relation to decisions about healthcare preferences and assesses the extent to which this is compatible with the identities promoted in Government policy. We suggest that in circumstances where individuals feel both a sense of personal entitlement and a desire to be supportive of the needs of other members of the community, 'doing' ethical consumer can be fraught with discomfort and anxiety. These anxieties are exacerbated in a context where citizenship is increasingly being defined in terms of consumer identities, and making good (health) choices might be seen as distinguishing the civilised from the marginalised.
authors.affiliation: National Primary Care Research and Development Centre, University of Manchester, Manchester, UK. ruth.mcdonald@man.ac.uk
authors.forename: Ruth
authors.initials: R
authors.lastname: McDonald
authors.forename: Nicola
authors.initials: N
authors.lastname: Mead
authors.forename: Sudeh
authors.initials: S
authors.lastname: Cheraghi-Sohi
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Diane
authors.initials: D
authors.lastname: Whalley
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002755:Choice Behavior / Q000941:ethics*; D003258:Consumer Behavior; D005260:Female; D006076:Government; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D028701:Patient Rights / Q000941:ethics; D017060:Patient Satisfaction; D026684:Personal Autonomy; D011320:Primary Health Care / Q000941:ethics*; D012111:Residence Characteristics; D012962:Sociology, Medical; D006113:United Kingdom