The Ethical Foundations of Accompanying Patients: The Need for Institutionalization

Area of Science:

• Healthcare Ethics
• Patient Empowerment
• Qualitative Research

Background:

• The healthcare landscape is shifting towards patient empowerment and partnership.
• Accompanying patients (APs) are experienced individuals who support new patients, extending peer support models.
• The ethical underpinnings and tensions associated with the AP role are not well understood.

Purpose of the Study:

• To identify essential skills and values for Accompanying Patients (APs).
• To explore the ethical tensions experienced by APs within healthcare settings.
• To analyze the integration of APs within the broader healthcare system.

Main Methods:

• A qualitative study was conducted using in-depth interviews with 19 APs in Québec, Canada (January-May 2021).
• Thematic analysis was employed to examine participant motivations, skills, values, and experiences.
• Tannahill's public health ethics framework was used to interpret identified ethical tensions.

Main Results:

• Core values for APs include empathy, respect, and altruism, with experiential knowledge being paramount.
• APs value independence for building trust but recognize the need for system integration for sustainability.
• A key ethical tension exists between the core philosophy of APs and their need for systemic integration.

Conclusions:

• Independence and authenticity for APs can coexist with institutionalization, professionalization, and remuneration.
• Successful AP programs require alignment with patient partnership philosophy, flexible criteria, and self-regulation.
• Addressing the ethical tensions is crucial for sustainable and effective AP roles in healthcare.