'Decolonising' the Clinical Encounter via Multi-Criteria Decision Support.

Area of Science:

• Health Services Research
• Philosophy of Medicine
• Public Health Policy

Background:

• Jürgen Habermas' theory of communicative action and instrumental rationality.
• The concept of 'colonisation of the lifeworld' in healthcare contexts.
• Existing tensions between strategic and communicative rationality in clinical encounters.

Purpose of the Study:

• To explore the application of Habermasian theory to Canadian and Danish healthcare systems.
• To propose a model integrating communicative action with means-end rationality.
• To investigate the role of decision support in achieving 'communicative means-end rationality'.

Main Methods:

• Analysis of healthcare systems through the lens of Habermas' theory.
• Critique of Habermas' dichotomy between communicative action and instrumental rationality.
• Proposal for a decision support system based on Multi-Criteria Decision Analysis (MCDA).

Main Results:

• Both Canadian patients and Danish General Practitioners experience 'colonisation' of their lifeworlds.
• Communicative action, when interwoven with means-end rationality, can enhance clinical encounters.
• Multi-Criteria Decision Analysis (MCDA) offers a framework for 'communicative means-end rationality'.

Conclusions:

• Healthcare systems can benefit from integrating communicative and instrumental rationality.
• Decision support tools like MCDA are crucial for fostering sincerity and autonomy in public health.
• Achieving mutual understanding requires a nuanced approach to rationality in clinical settings.