Patient-Centered Measurement

Ethics, Epistemology, and Dialogue in Contemporary Medicine

Author: Leah M. McClimans

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Contemporary medicine is Janus-faced. Evidence-based medicine is one face, emphasizing evidence, statistics, and method. Patient-centered care is the other, prioritizing patient experiences, judgement, and values. Government agencies, policy makers, major insurers and clinicians have sought ways to bring these approaches together, and the questionnaires that patients must fill out at the doctor's office or hospital are its most common manifestation. Leah M.McClimans examines one such integrative approach, patient-centered measurement. Patient-centered measurement is the idea that patient perspectives on, for instance, physical functioningor quality of life, should play an evidentiary role in determining how effective a drug is taken to be, the degree to which a hospital provides good quality care or whether a particular intervention should be funded by an insurer. Patient-centered measurement treats patient perspectives on par with more traditional metrics such as mortality, morbidity, and safety. But how can measurement, which relies on standardization, represent patient perspectives, which, if not idiosyncratic, are at leastvarious and changeable? Leah M. McClimans investigates the history and philosophy of patient-centered measurement, examining the use and role of patient questionnaires, and explores howpatient-centered measurement sits within the contemporary preoccupation with evidence-based medicine.

Critic Reviews

The book is an excellent example of philosophy of medicine done well. It engages in detail with debates in philosophy and science, drawing on philosophical resources to illuminate them theoretically and provide guidance on connected practical and ethical issues. The approach challenges some assumptions about wellbeing and measurement that have rarely been articulated. McClimans' analyses of a range of measurement-related concepts are important advances in philosophical engagement with patient-centred medicine and measurement science and the epistemological and ethical issues they generate. Mary Jean Walker, American Journal of Bioethics

About the Author

Leah M. McClimans is a Professor in the Philosophy Department at the University of South Carolina and co-Director of the Ann Johnson Institute for Science, Technology, and Society. She received her PhD at the London School of Economics in 2007. She has authored numerous articles on measurement in quality of life research, clinical ethics, and the entanglement of ethics and evidence. Before coming to the University of South Carolina she held apost-doctoral fellowship at the University of Toronto's Joint Centre for Bioethics (2006-2007). She also held an Ethox Research Fellowship (2009-2010) at the University of Warwick Medical School and a Marie Curie ASSISTIDFellowship (2016-2018) at the University College Cork School of Nursing.