The underlying ethic of care in nursing might suggest the need to explore other models of the goals of healthcare distinct from the bio-medical model that has been influential for so long. But what might such a model be? One possibility would be to borrow from the recovery movement in mental health and devise a recovery model with perhaps more general application to any conditions where simply getting better is not always a possibility.
In the UK, a recent policy paper published by the Sainsbury Centre for Mental Health called ‘Making recovery a reality’ begins by summarising some key points of emphasis which, it is suggested, characterise any broadly recovery-based approach. These points include:
Recovery is about building a meaningful and satisfying life, as defined by the person themselves, whether or not there are ongoing or recurring symptoms or problems.
Recovery represents a movement away from pathology, illness and symptoms to health, strengths and wellness.
Hope is central to recovery and can be enhanced by each person seeing how they can have more active control over their lives (‘agency’) and by seeing how others have found a way forward.
Self-management is encouraged and facilitated. The processes of self-management are similar, but what works may be very different for each individual. No ‘one size fits all’.
The helping relationship between clinicians and patients moves away from being expert / patient to being ‘coaches’ or ‘partners’ on a journey of discovery. Clinicians are there to be “on tap, not on top”.
People do not recover in isolation. Recovery is closely associated with social inclusion and being able to take on meaningful and satisfying social roles within local communities, rather than in segregated services.
Recovery is about discovering – or re-discovering – a sense of personal identity, separate from illness or disability. [Shepherd Boardman and Slade 2008: 0]
But if such a model is really to be distinct from a bio-medical model, it has to be more than just a valued particular set of values. It must say something more about what health or wellbeing actually is. What might that be?
Reading:
Thornton, T. and Lucas, P. (2010) ‘On the very idea of a recovery model for mental health’ J Med Ethics 37: 24-8