A brief history of empowerment: response to discussion with Julianne Cheek

Abstract

Empowerment has gained prominence in health care as an ideal to underpin practitioner – client/patient relationships. Its advocates see it as preferable to paternalistic or authoritarian models and practices, partly because of the humanistic values that shape it and partly because it is believed to improve efficiency in health care delivery because it makes compliance to treatment regimes and to health promoting advice more likely. However, as Cheek notes in her paper, there are plenty of situations in which it is difficult to find anything approaching empowerment in practice. This paper, which develops Cheek's arguments further, examines some of the historical and philosophical origins of empowerment, traces its trajectory through post-World War II societies into health and welfare values and finally asks whether nurses and other health care workers face significant contradictions if they are to take seriously the call to ‘empower’ their patients.