Patients’ conceptualizations of responsibility for healthcare: A typology

  • Heavey, E. (Speaker)
  • Justin Waring (Contributor to Paper or Presentation)
  • Aoife De Brún (Contributor to Paper or Presentation)
  • Pamela Dawson (Contributor to Paper or Presentation)
  • Jason Scott (Contributor to Paper or Presentation)

Activity: Talk or presentation typesOral presentation


Patients’ experiences of care in general and safety in particular have long been a focus within medical sociology. However, there remains little sociological understanding of how patients conceptualise responsibility for care, and less still about how they conceptualise responsibility for safety. This absence is striking, given the current emphasis on engaging patients as active participants in their own healthcare, including their own safety. Such involvement requires patients to recognise and accept some level of responsibility; understanding whether and how they perceive this responsibility, and how it relates to their perceptions of professional responsibility, is a vital step in encouraging engagement and - of equal importance - mitigating an absence of engagement.

This paper examines how patients conceptualise responsibility for their healthcare and make sense of the complex boundaries between patient and professional roles. Focusing on the specific case of patient safety, narrative methods were used to analyse semi-structured interviews with 28 patients recently discharged from hospital in England. Patients told stories about their own and others’ experiences in the hospital setting, including experiences of being or feeling safe and experiences of harm or risk. These stories variously attributed responsibility to staff, to patients, and to both groups.

We present a typology of attribution, which demonstrates that these attributions are informed by two dimensions of responsibility: basis and contingency. The basis of responsibility is the reason for holding an individual or group responsible. The contingency of responsibility is the extent to which that attribution is contextually situated. The paper contributes to knowledge about responsibility in complex organisational environments, and offers a set of conceptual tools for exploring patients’ understanding of responsibility in such contexts. There are implications for addressing patient engagement in care, within and beyond the field of patient safety.
Period11 Sep 201913 Sep 2019
Event titleBritish Sociological Society - Medical Sociology Society Annual Conference
Event typeConference
LocationYork, United KingdomShow on map
Degree of RecognitionNational