S36-02 - The Shift of Responsibility in the Care System During the Last Decades

Abstract

The paper deals with the change in the attribution of responsibility in the care system during the 2nd half of the last century. The shift went from the rather parentalistic attribution of responsibility to the professional site (psychiatrist, psychiatric institution, its runner) with “de-powerment” of patients, to “em-powerment” and attribution of responsibility to patients and their social systems. This development was influenced by general societal movements (as the human rights), ethical teachings (Hans Strotzka in Austria and Hans Jonas internationally) and a growing awareness for the complex process in the illnes itself and the possibilities to behave under the condition of illness. Nowadays there should be a “topography” of responsibility in care processes with changing foci dependent on the respective capacities to cope with responsibility and the result of negotiating the respective coping power. A fair search for balanced results as fairness in the evaluation of outcomes as well is needed - but not allways reached dependent on the conflicting expectations toward professionals in our societies (as protection versus freedom).