We’re big on The Self these days, aren’t we? Self-care, self-management, self-disclosure, self-efficacy, self-directed learning, self-examination, self-testing, self-administration of medication, self-actualisation: you name it, the 21st century Western individual is depicted as doing it or striving for it. What is more, professional practice and medical ethics are increasingly defined in a way that valorises the patient’s Cartesian self. We must respect their autonomy, share decisions with them, make ourselves accessible to them, and protect their data, where ‘them’ is actually a singular term, referring to ‘him’ or ‘her’.
Yet as family doctors, we also know that few people — and even fewer truly healthy people — are …