Person-centered care revisited: From problematizing its conceptual and methodological assumptions to proposing alternative foundations

Abstract

Person-centered care has achieved near-universal endorsement as a hallmark of quality in healthcare. Yet its status as an unquestioned “good” risks obscuring the assumptions that underpin it. Drawing on the problematization methodology, this paper critically examines the conceptual foundations of person-centered care to reveal how its dominant formulations may inadvertently constrain theory, research, practice, and evaluation. We identify twenty underlying assumptions grouped into six categories: normative-ethical, epistemic-psychological, practical-organizational, ontological-identity, justice, and measurement, and assess why they merit rethinking. These assumptions, such as personhood as individual autonomy, partnership as symmetrical collaboration, and care quality as measurable output, are shown to privilege individualism and standardization. To unsettle these taken-for-granted premises, this paper develops alternative assumption grounds that reconceptualize person-centered care as an emergent and context-dependent practice. Personhood is reframed as co-constructed within relationships; partnership as negotiated co-agency shaped by power and circumstance; and dignity as enacted through everyday attentiveness and mutual recognition. This reorientation shifts ethical and practical focus from implementing person-centered care as a fixed model toward cultivating conditions in which care can be continuously co-created. Rather than offering replacements or definitive solutions, the proposed alternatives serve as generative provocations aimed at stimulating critical dialog and new research directions. We argue that the future of person-centered care lies not in further technical refinement but in reimagining care as a moral and relational process, i.e., as something created with rather than delivered to persons. By cultivating reflexivity and moral imagination at personal, professional, and organizational levels, healthcare can better sustain the humane and contextually grounded spirit that person-centered care is meant to embody. © 2025 The Authors