title: Patient and citizen participation in health: the need for improved ethical support.
abstract: Patient and citizen participation is now regarded as central to the promotion of sustainable health and health care. Involvement efforts create and encounter many diverse ethical challenges that have the potential to enhance or undermine their success. This article examines different expressions of patient and citizen participation and the support health ethics offers. It is contended that despite its prominence and the link between patient empowerment and autonomy, traditional bioethics is insufficient to guide participation efforts. In addition, the turn to a "social paradigm" of ethics in examinations of biotechnologies and public health does not provide an account of values that is commensurable with the pervasive autonomy paradigm. This exacerbates rather than eases tensions for patients and citizens endeavoring to engage with health. Citizen and patient participation must have a significant influence on the way we do health ethics if its potential is to be fulfilled.
authors.affiliation: a Glasgow Caledonian University.
authors.forename: Laura
authors.initials: L
authors.lastname: Williamson
mesh_terms: D026688:Bioethical Issues; D001709:Biotechnology; D003256:Community Participation / Q000639:trends; D003657:Decision Making; D006291:Health Policy; D006801:Humans; D010358:Patient Participation / Q000639:trends*; D026684:Personal Autonomy; D011320:Primary Health Care / Q000941:ethics*; D011634:Public Health / Q000941:ethics*; D011786:Quality Control; D011787:Quality of Health Care / Q000941:ethics*; D012648:Self Care; D012945:Social Values
keywords: decision making; health policy; primary care; public health