Introduction to Person Centered Medicine

Abstract

Person Centered Medicine (PCM), as a concept and programmatic movement, places the whole person as the center of health and as the objective and protagonist of health actions. To understand the bases, scope and implications of this concept it is necessary to examine its historical unfolding, collaborative and institutional construction, and conceptual and scholarly maturation.

An account of the historical development of PCM must start from mutual social support as crucial for life and health protection in Neanderthal times, to the broad personalization of health and medicine with pointed attention to ethical considerations in Eastern and Western earliest civilizations and the fascinating person-centered health notions in the Andean cosmovision, African Ubuntu humanism, and the Islamic medical golden era. These early personalized perspectives are reflected in WHO’s definition of health focused on well-being. Of seminal value at the beginning of the Contemporary Era, are the ethics work of Emmanuel Kant and the French Revolution’s Declaration of Human Rights.

Building on twentieth century specific person-centered care proposals and responding to prevalent reductionist and dehumanizing models of medical education and health care, programmatic movements for person centered medicine emerged in the twenty-first century, exemplified by the International College of Person-Centered Medicine in collaboration with the World Psychiatric Association, the World Medical Association and the World Health Organization. Institutional maturation has been substantiated through 14 annual Geneva Conferences and nine annual International Congresses of PCM, along with the development of regional networks.

In terms of conceptual development, seeking the person at the center of medicine, has meant a medicine of the person, for the person, by the person and with the person. Articulating science and humanism, PCM strives for a medicine informed by evidence, experience and values and aimed at the restoration and the promotion of health for all. A major step forward involved a systematic conceptualization study of PCM funded by the World Health Organization and encompassing critical literature reviews and broad international consultations. This elucidated eight PCM core concepts, i.e., ethical commitment, holistic framework, cultural awareness and responsiveness, relational focus, individualized care, common ground for collaborative diagnosis and care decision making, people centered and integrated organization of services, and person-centered health education and research; from which a Person centered Care Index (PCI) was designed and validated.

The scholarly development of PCM includes, first, research on person-centered diagnosis, mainly involving the practical application of the Person centered Integrative Diagnosis model through the practical Latin American Guide for Psychiatric Diagnosis. It also has involved research with the Person centered Care Index to assess level of person-centeredness in prototype Latin American hospitals. A second scholarly line has encompassed educational programs on person-centered health care. Of considerable scholarly value has also been the publication of the International Journal of Person Centered Medicine in partnership with the University of Buckingham Press in London. Another major publication activity refers to textbooks, including the recently published Person Centered Psychiatry book and an educational monograph on Seeking the Person at the Center of Medicine.

The present textbook on Person Centered Medicine reviews this programmatic movement as it has evolved to date and its resulting knowledge base. The book structure encompasses an Introduction to the field and four sections on Principles of Person Centered Medicine, Methods for Person Centered Clinical Care, Person Centered Care in Specific Health Fields, and Empowerment Perspectives for Community Members and Health Professionals. Its 42 chapters are authored by 105 clinician-scholars coming from 25 different countries and all world regions, i.e., North America, Latin America, Europe, Africa, the Middle East, Asia and Oceania. Its vision and goals involve total health for a total person. Ongoing work and upcoming publications would focus on redesigning health systems fit to purpose, articulating science and humanism, and integrating ancestral knowledge and wisdom, community members’ self- and mutual-care, and the contributions of all health-relevant social sectors.