Describing a requirement for patient autonomy in medical treatment

Question

I am listing a set of desirable characteristics of a medical treatment in a certain setting -- essentially criteria for acceptability. Each section starts with a single word that identifies the section, followed by a number of parts and sub-parts that define and qualify it it in my current context.

The first three were easy:

• Effective
• Affordable
• Safe

But the fourth one has me stymied. I am looking for a single word, or at most a two-word phrase, that means something like "preserves autonomy" or "allows the patient control over their own fate."

Two comments here:

The medical profession is virtually unique in the extent to which it is allowed to make decisions for mentally competent adults, based on their own good, without their consent. This is perhaps most obvious with respect to the prescription system, but it really pervades medicine.There are reasons for this of course, but there are also reasons to limit these powers, and a great deal of evidence that maintaining an individual's belief that they control their own life itself has medical benefit.

The second problem in parallelism is that the first three terms are all descriptions of the treatment, not the person. However, there is an implicit requirement, which is made explicit in subpoints of each, that the treatment must have that characteristic with respect to the individual to which it is applied: Effective for you. Affordable by you.

All the things I have been able to come up with after combing several thesauruses either suffer from peculiar failures of parallelism (e.g. "Autonomy") or are long and awkward ("Preserves self-determination")> The latter also makes me uncomfortable for an additional reason, though I may be willing to live with it. It implies that the person has self-determination unless the treatment takes it away. But in the absence of treatment, this may just be the freedom to die. Ultimately, the longer document of which my current document is merely a summary or an elaborated table of contents will want to argue under this point the right to be fully informed consent, the right to be free of unwanted treatment, and in some cases, the right to treatment even over medical objection, as when a drug known to be effective and approved by many other countries has not yet been approved by the FDA. I would ideally like a term that walks the line between these two extremes, as, e.g. "Preconditioned by informed consent," which avoids either extreme but is nonetheless horrible.

Yet for all these complications, I have a strong intuition that there is a right word that is just eluding me. And it is driving me crazy. Help?

andrewH

Answer 1

Your question is informative and fascinating. That does not make it easy to answer. I will try, if only to stimulate others to react.

I have discounted attentive because that aspect goes without saying. I think of a spectrum of meaning associated with care, respect, concern, dignity and heed. This leads me to a couple of suggestions that, while not all-embracing in the manner of your first three words, are susceptible to expansion and explanation in your sub-headings.

The first is respectful. Respectful of the patient rather than for them.

The second is heedful. Again, of rather than for the patient.

Of these, I imagine respectful is more immediately understood by most people but I feel that heedful might be preferable once expanded. It includes the aspects of attention, respect, listening and demurring (which, like deferential, is not a candidate, because it takes too much power from the doctor).

Answer 2

You could perhaps describe the treatment as empowering:

1 : to give official authority or legal power to

2 : to enable

3 : to promote the self-actualization or influence of

(Merriam-Webster) which does imply giving control or self-determination to the patient. If that goes too far, enabling might be better.

Answer 3

I've racked my brain and, unfortunately, still have not landed on that singularly felicitous word/phrase, but I figured, for good measure, I might as well contribute my second-string findings for consideration. Both revitalizing/vitalizing, meaning to (re-)endow with vitality, may bear too body-centric a connotation and therefore be unpleasantly rigid for your purposes. Restorative, of course, presupposes some pre-existing cognitive deficiency thereby indirectly mitigates the consent imperative, reducing it to a mere pleasantry. Same with recuperative--it's sort of the flip-side to "preservative".

So all I'm left with to offer are far less value-neutral options, among them ethical, virtuous, or even honor-bound. All of these invite a degree of subjectivity that may be objectionably hazardous in a world as perilous as healthcare. But just now dawning on me are considerate and courteous--both of which I regard as the most comprehensive and agreeable so far, for they both nod to the importance of dignity.

Oh, and, empowering was among the first few that came to me while reading your post, so I co-sign that one too. (I'm assuming you aren't too keen on resorting to some more obscure option and outing yourself as a member of the verbal vanguard and raising eyebrows in what I presume to be some kind of clinical document, but autonomize is recognized in Merriam-Webster and can be used to mean to lend autonomy.