Reconstructing consumer participation in evidence-based health care: a polemic

Abstract

Consumer participation in the evidence-based health-care movement is largely seen as important by those who promote evidence-based health care but is surrounded by a range of competing discourses that variously critique medicine, nursing or health-care systems; situate consumers as powerless players within systems characterized by controlling health professionals; or politicize the role of the consumer as activist and defender of patient rights. This paper explores these competing discourses and develops an argument that asserts that the social construction of the evidence-based movement has rendered previously accepted terminology regarding the user or receiver of health services relatively meaningless. The result has been the ‘politicisation’ and ‘professionalisation’ of consumer participation and the time has come to reconstruct consumer participation in evidence-based health care – from the generation of evidence to guideline development.