Clarifying the concepts, epistemology and lexicon of person-centeredness

The full title of this editorial in the European Journal for Person Centered Healthcare is “Clarifying the concepts, epistemology and lexicon of person-centeredness: an essential pre-requisite for the effective operationalization of PCH within modern healthcare systems”

Written by Andrew Miles and Jonathan Elliott Asbridge, it begins:


In a previous Editorial [1], we referred to person-centered healthcare (PCH) as a new way of ‘thinking and doing’ in clinical practice, one that had become necessitated by medicine’s relentless empiricism, its positivistic reductionism and its failure to care for patients as individuals, which is to say as persons.

In this, we found ourselves able to agree with Charon [2], but needing to distance ourselves from an over-arching description, by Weatherall, of modern medicine as a ‘failure’ [3].

Indeed, modern advances in medicine may accurately be described as a triumph – but a triumph of scientific and technological advance only, not a triumph represented by an increased excellence in clinical practice per se, if excellence (versus competence) is to be defined as the successful translation of such advances to patients within an overtly humanistic framework of care – the process which represents and causes contextualisation [4].

If we add the statistics which demonstrate high rates of medical error and iatrogenic injury within health services and also the increasingly frequent institutional failings of major hospitals and the Care Home scandals of recent times to medicine’s tendency to view patients as subjects or objects or complex biological machines requiring some sort of ‘fixing’, then it is clear that modern healthcare systems are experiencing little short of an existential crisis. Such a crisis – and the high burn out rates of clinicians which also contribute to it, can no longer be ignored or ‘whitewashed’ over …”

The remainder of the editorial includes following subheadings:

  • Person-centered healthcare
  • What other form of medicine could there possibly be?
  • Competence versus excellence in clinical care
  • Medicine and its ongoing professionalism
  • Conclusion

Read more here.

  1. Miles, A. & Asbridge, J.E. (2014). Contextualizing science in the aftermath of the evidence-based medicine era: on the need for person-centered healthcare. European Journal for Person Centered Healthcare 1, 285-289
  2. Charon, R. (2006). The self-telling body. Narrative Inquiry 19, 191-200.
  3. Weatherall, D. (1996). Science and the Quiet Art: The Role of Medical Research in Health Care. New York: W.W. Norton.
  4. Miles, A. (2013). Person-centered medicine – at the intersection of science, ethics and humanism. International Journal of Person Centered Medicine 2, 329-333.


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