Vikki Entwistle is Professor of Bioethics and Director of the Centre for Biomedical Ethics (CBmE) at the Yong Loo Lin School of Medicine, National University of Singapore. She was previously (through May 2018) Professor of Health Services Research and Ethics at the University of Aberdeen in Scotland.
In broad terms, Vikki’s research aims to develop practically useful thinking about ethical aspects of healthcare policy and practice. She is particularly interested in ideas about the quality of healthcare (including concepts such as ‘person centred care’ and ‘shared decision-making’) and the pursuit of fairness in health services. Vikki engages collaboratively with clinicians and patient-advocates, as well as academic colleagues, to help ensure her work is relevant and useful. She draws on theories and methods from a range of social sciences and philosophy, striving to take seriously the messy realities (social complexities) of healthcare and of people’s lives and wellbeing.
Researching (for) person-centred practice
Health services often commit to be ‘person-centred’ (or similar) in their value statements, and ‘person-centredness’ features alongside safety and effectiveness as a key aspect of healthcare quality. In practice, experiences of healthcare suggest services often fall short of person-centred ideals, but it is not clear what should happen to improve things.
In this lecture, I will consider some of the core ideas that underpin the advocacy of person-centred practice. I will suggest that as health services and practitioners work to help prevent and address health problems in their communities, they should (be equipped and able to) treat the people they serve with compassion and respect, recognising the full range of ways in which human beings can suffer and flourish, and taking seriously each person’s own perspectives on what matters and how they should live their lives.
I will illustrate how several different types of research, including a study of health professionals’ experiences of supporting people with diabetes and other long-term conditions, have contributed to the development of more ethically grounded and practically useful understandings of person-centred practice. I will also show how some attempts to develop and assess the effectiveness of interventions to promote person-centred practice have seemed to lose sight of the values that underpin the concept. Stressing the importance of taking the social-relational complexity of human experiences and capabilities seriously, I will end by opening up some questions about a future research agenda for research to support person-centred practice in primary care contexts in the Asia-Pacific Region.
Researching (for) person-centred practice in primary care in the Asia Pacific region
This series of three workshops will engage participants in small group activities and larger group discussions that aim (a) to develop ideas about an agenda and considerations for the design and conduct of research to investigate and support person-centred practice in primary care contexts in the Asia-Pacific region; and (b) provide opportunities to learn from and with each other and develop skills to recognise and navigate some of the challenges of such research.
There will be some flexibility, depending on participant interest and where initial activities and discussions lead us, but in outline, the three sessions will consider:
Research agenda setting: what kinds of questions should research help us tackle in the pursuit of person-centred practice?
Participants will share ideas about the experiences and concerns of health professionals, patients and communities in our various Asia Pacific contexts, consider how well ideas and studies of person-centred practice from elsewhere resonate, and engage in an exercise to propose and prioritise research questions to take forward.
2. Researching patients’, communities’ and practitioners’ perspectives: how can we take diverse views seriously?
Participants will consider some of the practical and ethical challenges of finding out and thinking critically about the experiences of a diverse range of key stakeholders (including people who are particularly socially vulnerable) and their implications for the pursuit of person-centred practice.
3. Evaluation research: how can we assess progress in person-centred practice?
Participants will need to think critically about criteria and methods for evaluating interventions to promote person-centred practice as they work together to design an evaluation study.
PROFESSOR VIKKI ANN ENTWISTLE
Centre for Biomedical Ethics, Yong Loo Lin School of Medicine (NUS Medicine) Singapore