Two variants of ‘constrained participation’ in the care of vulnerable adults: A proof-of-concept study

Kristján Kristjánsson*, Kristín Thórarinsdóttir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


There has been a radical turn towards ideals of patient autonomy and person-centred care, and away from historically entrenched forms of medical paternalism, in the last 50 years of nursing practice. However, along the way, some shades of grey between the areas of ideal patient participation and of outright patient non-participation have been missed. The current article constitutes an exploratory proof-of-concept study of the real-world traction of a distinction-straddling concept of ‘constrained participation’ and its two sub-concepts of ‘fought-for participation’ and ‘forced-to participation’. In order to concretise these additions to the conceptual terrain of person-centred participation and its anti-theses, we apply them to themes in the care of vulnerable older adults. In the final section, we close by eliciting some characterological, educational and clinical implications of adding these new tools also to the conceptual repertoire of nursing practice and education.

Original languageEnglish
JournalNursing Ethics
Publication statusPublished - 17 May 2023

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Other keywords

  • constrained participation
  • forced-to participation
  • fought-for participation
  • patient participation
  • vulnerable older adults


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