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A Normative Practice Approach to Health Care

This chapter explains how and why healthcare might profit from a normative practice approach (NPA). This approach sketches a conceptual and normative framework that helps to locate and identify relevant points of view for clinical practice as well as for policy making in healthcare. The chapter starts in medias res: in the consulting room, in the encounter between clinician and patient. What kinds of relations are relevant for the understanding of what is going in the patient who feels ill and between the patient and the doctor (or nurse)? Are there normative principles and values which guide these relationships? The focus then broadens to the meso- and macro-contexts of current medicine and healthcare. The NPA will be re-introduced. Its relevance is shown for topics like the increase in the administrative burden in medicine, the role of expert knowledge, the hospital and its purposes, and the changing focus of medicine given the rapid changes in the macro-sphere. The chapter ends by saying that the NPA may help in different ways: by taking it as a point of reference; by relating the different normative dimensions to core responsibilities of doctors, other employees, and stakeholders beside medical professionals; and by relating these core responsibilities to the relevant contexts in which these doctors, other employees, and stakeholders are working.