2 Terminology: patients or people?

In this course ‘the patient’ has been referred to on several occasions. One reason is the universal usage of the term and the ease with which it is understood. To identify someone as a patient immediately situates them as someone in receipt of medical treatment. However, the term itself is not without difficulty, as sociologists critical of medicine have been quick to point out, since it carries associations of power and authority.

Labelling theory is a useful concept that assesses how an individual acts and behaves once they have been identified or categorised by society. It is a popular concept in criminology, particularly in studying how people become repeat offenders once they have been labelled ‘a criminal’. This principal of labelling can apply to what happens when a person is identified as ‘a patient’.

The connotations of being medically defined and labelled as a patient are especially potentially harmful when a person is dying, as it suggests that the dying person is the passive partner in the patient–practitioner relationship and therefore dependent on clinicians.

The hospice movement has tried to distance itself from the unequal doctor–patient relationship, focusing instead on autonomous patient-centred care and services. In this alternative model of health care delivery, the dying person is actively encouraged to be the primary decision maker. However, the extent to which dying people can unilaterally decide on such things as length of stay is limited.