[Views of psychiatrists on patients' responsibility for their own health. A qualitative study]

In the Netherlands patients are increasingly being required to take responsibility for their own their health. However, an important problem not yet resolved is whether psychiatric patients are able or well enough to shoulder this responsibility.

To explore the normative views of psychiatrists concerning their responsibility of their patients' health.

We performed a qualitative research in which 15 psychiatrists were interviewed with the help of a list of topics. The verbatim accounts of the interviews were analysed and interpreted by two researchers.

Psychiatrists differed in their views on the responsibility of patients for their own health. Some psychiatrists defined patient responsibility as a personal quality or disposition and regarded patients as being in principle responsible; others considered patient responsibility to be a construct or result of the therapeutic relationship. These two groups had different views about the moments and the ways in which patient responsibility becomes problematical. In addition, they had opposing views on current developments in government policies.

Psychiatrists differ in their interpretation of patient responsibility. This means they differ not only in their views on government policy but also probably in the attitudes they adopt in their daily practice. These differing attitudes to patient responsibility need to be looked at critically because they have a bearing on the observance of ethical norms and on the need to respect patients' autonomy.