Review

Good choice

Evidence-based patient choice
Tony Hope
King’s Fund, 1996

In the past five years or so it has become almost obligatory to preface any decision in health care with the dread phrase ‘evidence-based’. In itself, this is a remarkable phenomenon; yet when the attempt is made to set it alongside the notion of patient choice, it seems to border on contradiction. While the evidence-based ideal is firmly rooted in an ideology of efficiency and rational planning, the challenge to clinical practice from patient choice is bottom up and consumerist.

Despite this apparent conflict, Tony Hope does a good job of bringing the two ideas together in a useful, interesting and readable way. He provides an overview and exploration of the ‘EBPC’ concept and the issues which arise, rather than a definitive text.

Although some problems with the idea are noted, the emphasis here is practical rather than theoretical and there is no sustained attempt to critically engage with the contradictions and clarify exactly what would be required (movement of resources? changes in power?) in order to bring EBPC into being. Nonetheless, this is worthwhile as a clear and concise introduction to the idea.