Semantics of patient choice: how the UK national guideline for depression silences patients

Abstract

Several stakeholders, including the National Survivor User Network and the British Psychological Society, have called for the National Institute for Health and Care Excellence (NICE) to include an up-to-date review of patient experience research in the new depression guideline. In response, the Guideline Committee (GC) postponed publication, the guideline now due in February 2020. Yet the GC also stated it will not review patient experience research. Instead, it will incorporate a new element of ‘patient choice’, without elaborating what this entails. Here, we attempt to untangle a number of similar sounding terms including ‘patient choice’, ‘patient preference’, ‘patient experience research’ and ‘service user involvement’ in terms of how they relate to the NICE depression guideline. We argue that by conflating these concepts and implying that one will serve the purpose of another equally well, NICE risks leaving patients without a real voice, their perspectives buried in semantically void rhetorical jargon.