Wilson P M
Department of Post Registration Nursing, University of Hertfordshire, Hatfield, Hertfordshire, UK.
Health Soc Care Community. 2001 May;9(3):134-42. doi: 10.1046/j.1365-2524.2001.00289.x.
The rise in chronic illness and comorbidity in Western society has resulted in an increasing emphasis on self-care initiatives. In the United Kingdom this is exemplified by the Expert Patient policy. This paper discusses the Expert Patient initiative as an example of the State's third way approach to public health. The extent to which this policy challenges conventional power relationships between professional and patient, and fosters equal partnership is examined. In particular, how expert is defined and whether a professional understanding of the term is reconcilable with a patient's expertise is debated. The paper argues that the Expert Patient initiative is unlikely to reconstruct chronic illness and may further complicate the State's responsibility in meeting the needs of those with chronic illness. Issues of power within self-care are explored to illuminate the policy, and this paper argues that the Expert Patient initiative is an example of Foucault's notion of pastoral power. Although the Expert Patient policy focuses on the rights and responsibilities of those with chronic illness, this paper concludes that there is no corresponding strategy to challenge professionals' assumptions toward those with chronic illness.
西方社会慢性病和共病的增加导致人们越来越重视自我护理举措。在英国，“专家患者”政策就是一个例证。本文将“专家患者”倡议作为国家公共卫生“第三条道路”方法的一个例子进行讨论。考察了该政策在多大程度上挑战了专业人员与患者之间的传统权力关系，并促进了平等伙伴关系。特别是，探讨了“专家”是如何定义的，以及该术语的专业理解是否与患者的专业知识相协调。本文认为，“专家患者”倡议不太可能重构慢性病，可能会使国家在满足慢性病患者需求方面的责任更加复杂。探讨了自我护理中的权力问题以阐明该政策，本文认为“专家患者”倡议是福柯牧师权力概念的一个例子。虽然“专家患者”政策关注慢性病患者的权利和责任，但本文得出结论，没有相应的策略来挑战专业人员对慢性病患者的假设。
