This chapter focuses on some of the mainstream and circumscribed examples of rethinking agency. Once one starts seeing and treating people as healthcare actors—as having something to contribute to their own care and to health systems and environments—many possibilities emerge. Some of these are already absorbed into mainstream thinking and others are more challenging or radical. The former includes the expectation that patients should play an active role in clinical decision making that affects them. The latter extend much more widely—questioning why ‘lay people’ are often allowed to be influential only in circumscribed instances, when their agency and perspectives could be equally influential in agenda setting and design decisions in all aspects of service planning, care provision, research, resource allocation and so on. This question highlights the potential to move beyond an individualist or consumerist conception of agency and towards more civic, social and democratic conceptions of social action.
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