‘Decolonising’ the clinical encounter via multi-criteria decision support (Preprint)

UNSTRUCTURED According to researchers drawing on the ideas of Jürgen Habermas, Canadian patients and Danish General Practitioners are experiencing ‘colonisation’ of their ‘lifeworlds’ by ‘the system’, Their suggested remedy is to ensure that the clinical encounter, freed of strategic rationality, re-prioritises Habermasian ‘communicative action’ aimed at mutual understanding. However, Blau shows that such communicative action is, and should be, inextricably interwoven into means-end rationality, when Habermas’ caricature of the latter is rejected. We argue that the decision support framework provided by Multi-Criteria Decision Analysis can help produce the ‘communicative means-end rationality’ essential in a public health service based on role-respecting sincerity and autonomy. No ‘positivistic reduction’ is involved in the technique.