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Background: This paper aims to contribute to the discussion about patient‐centred care in surgery. It is contended here that the paradigm shift towards patient‐centred decision‐making in health care does not mean that patient values alone (or those of their proxies) should, uncritically, be the lead decision makers in determining surgical care. Methods: In support of that contention, three clarifications to our conception of autonomy will be offered. Results: First, autonomy may not be best positioned as the lead principle guiding healthcare decision‐making. Second, arguably, our traditional understanding of autonomy, as it might be applied to health care, is incomplete. Third, where autonomy is vested is contentious, and proxy decision makers can further complicate the decision‐making process. Conclusion: It will be argued that an approach of inclusive, non‐coercive and reflective dialogue seeking a consensual decision amongst all those affected is more appropriate for moral decision‐making in surgery. This dialogue is set in the actual reality of the patient's illness. During the discourse, each participant has equal rights to contribute and to be heard, equal duties not to coerce and equal co‐responsibilities to share the perspectives of others in the discourse, with an aim to reach consensus. [ABSTRACT FROM AUTHOR]

Objective To suggest that the patient movement is an emancipation movement. Background The patient movement is young and fragmented; and it can seem confusing because it lacks an explicit ideology with intellectual and theoretical underpinnings. Methods Drawing mainly on the experiences and the published writings of patient activists, the author identified eight aspects of the patient movement that could be compared with aspects of recognized emancipation movements: the radicalization of activists; the creation of new knowledge; the identification of guiding principles; the sense of direction; the unmasking of new issues; schisms within the movement and allies outside it; and the gradual social acceptance of some of the ideas (here standards of health care) that activists work to promote. Results Similarities between certain aspects of the patient movement and of the recognized emancipation movements were close. Conclusion The patient movement can be regarded as an emancipation movement, albeit an immature one. [ABSTRACT FROM AUTHOR]