Harmed patients gaining voice: Challenging
dominant perspectives in the construction of
medical harm and patient safety reforms
J.E. Ocloo, 2010
Journal Club 1 Philosophy
Luca Nulens (i6265001)
The case:
• Patient safety and reducing medical harm are the main topics of the study
• Study gathers evidence from self-help groups (Medical Harm Self-Help Network) + data from
patients affected from harm (BreakThrough Programma)
• 18 questionnaires and a written narrative account of patient experiences and observational
data were gathered from workshops
• Medical harm focuses on clinical markers and obsures social processes (addressing these
helps gathering knowledge which leads to a broader framework to address safety of the
patient)
The problems patients in “your” case set out to
solve
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The main problem of the case is patient safety in healthcare
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 Avoidable medical care is the major concern
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On average, 10% of hospital admissions result in a PSI (Patient Safety Indicators)
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Patient is not recognized as a stakeholder in decision making but as a passive receiver of
care
Why do these problems occur?
1. Patients trust the medical professionals blindly and do not question treatment
until harm is occurred
2. Patient safety movement is increasing over the years
Solutions offered by patients:
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Emphasis on the ‘embodied’ personal experiences (inform patients)
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Reduce the barriers after medical harm occured
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Voice gaining of harmed patients and contributions to the development of patient safety
reforms + raising questions about the control, dominance and power of the medical
profession
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From the experiences:
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More holistic approach is needed
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A more perspective/cultural shift is emphasized
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Wider perspective is needed
Reflection
• There is a shift from top-down relationship to bottom-up
• The patient should not be seen as solely a passive receiver of care but as an active
stakeholder
• Health care systems are usually based on medical evidence but should embrace both
medical and social processes
• It is important to look at ‘harm’ in a broader contextual framework