Ethical aspects of individualised care

Abstract

The ethical underpinning of ‘individualised care’ seems obviously related to the value of autonomy. What is less clear is how individualised care compares with other models of care such as person-centred care and evidence-based care. Models of care with an ethical underpinning need also to integrate evidence to improve health-care outcomes. The facts must, therefore, inform the values and vice versa. What is too rarely considered is which values, in addition to autonomy, underpin individualised care so this is expanded to provide a sufficient model of care across contexts and cultures. Does individualised care, for example, have relevance to public health? Drawing on two practice scenarios relating to care in clinical and public health settings, we argue that individualised care is most helpfully contextualised within a model of ‘integrative care’ informed byan ‘integrative ethics’. We develop a three-level model—individual, family and community—with scope to apply key ethical values. The approach we propose goes beyond a traditional autonomy-based model of individualised care towards an integrative bioethics with capacity to integrate the activities of advocacy, empowerment and activism.