Vikki Entwistle

Academic Associate

Profile

Vikki Entwistle joined the Centre for Biomedical Ethics in July 2018 as Director and Professor of Bioethics. She was previously Professor of Health Services Research and Ethics at the University of Aberdeen, Scotland, UK.

Vikki’s interests in ethics developed in the context of applied health services research. In the mid-1990s while working to develop information to help patients and health professionals consider the effectiveness of different healthcare options, she saw a need for judgements of effectiveness to better reflect patients’ perspectives on outcomes. She then started to raise and tackle questions about patients’ involvement in both treatment decision-making and research agenda setting. Several of her empirical studies of patients’ perspectives illuminated important shortfalls in the prevailing choice-dominated discourse on patient involvement. Vikki then started to draw on relational theorising about autonomy and on a capabilities approach to thinking about quality of life. This facilitated the development of more robust accounts of key concepts relating to person-centred care (including shared decision-making, support for self-management), and of more nuanced ethical arguments about healthcare and public health practices (including various forms of screening interventions).

Research

Vikki’s research aims to develop practically useful thinking about how health policy and clinical and public health practice can better contribute to human flourishing. Her approach to research is highly interdisciplinary, drawing on and integrating approaches from relevant social sciences and philosophy. Vikki collaborates with health professionals and people with lived experience of health conditions as well as with academic colleagues. Vikki is currently particularly interested in the ethical tensions that arise in the pursuit of healthcare that is good in multiple senses at once (e.g. safe and effective and person-centred and fair). She is developing a program of work that will investigate: how health professionals working in different practice settings in Singapore understand and work in practice to balance different aspects of good healthcare; what should count as doing this well, and why; and how health professionals could be better supported (and support each other) to provide all-around good quality services.

Current and recent research grants

2018-2023 – Co-investigator. “ ‘But why is that better?’ an investigation of what applied philosophy and ethics can offer to quality improvement work in healthcare”. Wellcome Trust Collaborative Award. Total value: GB£721,710. Principal investigator: Professor Alan Cribb (King’s College London).

2018-2021 – Co investigator. “Do you really know what I want? Voices of people with dementia in shared decision making about living well to the end of life.” Canadian Institutes of Health Research. Total value: CA$191,250. Principal investigator: Professor Susan Cox (University of British Columbia)

Selected Publications

Entwistle, V.A., Cribb, A., Watt, I.S., Skea, Z.C., Owens, J., Morgan, H. & Christmas, S. (2018) “The more you know, the more you realise it is really challenging to do”: tensions and uncertainties in ‘person-centred’ support for people with long-term conditions. Patient Education and Counseling, 101 (8): 1460-7.

https://www.pec-journal.com/article/S0738-3991(18)30153-8/abstract

Entwistle, V.A., Cribb, A., Owens, J. (2018) Why health and social care support for people with long-term conditions should be oriented towards enabling them to live well. Health Care Analysis, 26(1): 48-65.

https://link.springer.com/article/10.1007/s10728-016-0335-1

Morgan, H.M., Entwistle,  V.A., Cribb, A., Christmas, S., Owens, J., Skea, Z., Watt, I. (2017) “We need to talk about purpose”: a critical interpretive synthesis of health and social care professionals’ approaches to self-management support for people with long-term conditions. Health Expectations, 20(2): 243-259.

https://onlinelibrary.wiley.com/doi/full/10.1111/hex.12453

Rogers, W., Craig, W., Entwistle, V.A. (2017) Ethical issues raised by thyroid cancer over-diagnosis: the advantages of public health over clinical approaches. Bioethics, 31 (8): 590-598.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/bioe.12383

Carter, S.M., Entwistle, V.A., Little, M.. (2015) Relational conceptions of paternalism offer a way to rebut nanny state accusations against public health. Public Health, 129: 1021-1029.

https://www.sciencedirect.com/science/article/pii/S0033350615001225?via%3Dihub

Easton, P., Entwistle, V.A., Williams, B. (2013) How the stigma of low literacy can impair patient-professional interactions and affect health: insights from a qualitative investigation. BMC Health Services Research, 13: 319.

https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-13-319

Entwistle, V.A., Watt, I.S. (2013) Treating patients as persons: a capabilities approach to support delivery of person-centred care. American Journal of Bioethics, 13(8): 29-39.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746461/      

A more comprehensive list of publications is available here and on Google Scholar as well as Scopus