Exploration of the social and philosophical underpinning of ‘the patient’—what this means for people with a long-term condition

Abstract

Should healthcare professionals use the term ‘patient’? A patient is a social construct, in a biomedical model, in which each actor has their role to play. This model has been criticised as belonging to an era of medical hegemony and (mis)represents an individual seeking healthcare as one who is simply a passive participant and recipient of care. The ‘Language Matters’ campaign, for people living with diabetes, has sought to address the role of language in interactions between healthcare providers. A key point raised in the campaign is whether someone who feels well, but has ongoing healthcare input, should be referred to as a patient? In this article, we address the concept of a patient and how its use can belie a particular mindset (or ‘discourse’) in which power is established in a relationship and can lead to individuals being defined by their condition. However, for some linguistic communities (such as nurses and doctors), a patient may be considered less as one over whom they have dominion, but rather someone for whom they have specific responsibilities and duty of care. Drawing upon the philosophical theories of language—that the meaning and inference of a word is dependent on its use—we argue that the context in which use of the term patient occurs is crucial. Without more fundamental cultural disruption of the biomedical model, word substitution, in itself, will not change perception.