ABSTRACT
Individual choice is a widely celebrated ideal. This is hardly strange: who likes to be dominated by others? And yet this book starts out from doubts about this ideal. I do not question choice in general, but rather the generalisation of choice. Other ideals, like ‘good care’, suffer from this. In health care, on which this book concentrates, ‘patient choice’ and ‘good care’ may sometimes complement each other, but more often they clash. Practices designed to foster ‘patient choice’ erode existing practices that were established to ensure ‘good care’. People who are directly involved in health care (as professionals or as patients) have sad stories to tell about this. However attractive it may sound, when it comes to it, ‘patient choice’ does not always lead to the expected improvements. Why not? Where do things go wrong? To tackle these questions, I will not discuss the merits of the ideals of ‘individual choice’ and ‘good care’ in and of themselves, in isolation. Instead I will unravel some exemplary practices with which they are linked.1
