Understanding the ethical consumer: employing a frame of bounded rationality

This thesis is about ethical consumers. In some business circles ethical consumers are treated simply as one kind of consumer in a market society where a niche can be created to satisfy every preference. Conversely some advocates of more radical change propose consumer activism as part of a movement which will force ethical considerations into the decision-making of capitalist businesses and governments alike. Questions about ethics are central to consumer society. Unlike most recent research into the 'green' or 'socially conscious' consumer that has been based on either extensive quantitative surveys or focus groups, the research presented here analyses consumer decisions in a social context. Sixteen case studies of ethical consumers in differing circumstances are developed in considerable detail. Starting from the theoretical observation that being an ethical consumer presents apparently daunting difficulties, especially with respect to decision making, the research uses bounded rationality theory to explain how these cases maintain their self-image as ethical. From these data I suggest thinking of ethical consumers as adopting coping strategies. Those contributing to the study were seen to be 'distancing' themselves from practices they consider unethical, 'integrating' their lives around addressing the issues current in ethical consumer discourse and/or 'rationalising' their ethical consumption against their acceptance of consumer capitalism. Each strategy can be shown to reduce the scope and/or difficulty of decision making. Finally, consideration is given to the nature of ethical consumption as a political project. Individual consumers respond in diverse ways to a social discourse on any given ethical issue even where strong and clear consumption advice is given. I argue that ethical consumerism is limited by the capacity of individuals to give attention to more than a few actions. Its political significance is nevertheless enhanced by the unpredictability of consumer response

Talking together : consumer communities in healthcare

Consumer involvement in computer mediated communities (CMCs) is increasing particularly in high involvement services such as healthcare. This paper examines the role of CMCs as providers of patient information and support and the subsequent effect on the relationship between 'informed' consumers and health care providers. The evolving dialogue between consumers in virtual communities provides one key axis along which professional service consumption will evolve. The challenge for service consumers is to develop frameworks that facilitate robust dialogue and exchange of information and emotional support to complement their rising authority. The parallel challenge is for the established medical profession to recognise the consequences of this evolving dialogue and develop approaches to service delivery that effectively engage with consumers on the basis of this increasing authority

Crisis of confidence : re-narrating the consumer-professional discourse

The professional-consumer relationship in professional services has undergone unprecedented change. Relationships which were traditionally dominated by respect for professional status are in flux as increasingly educated consumers challenge the professional establishment. This paper considers the nature of the professional service consumer and the implications for professional service encounters. Based on qualitative interviews we identify four patterns of consumer-professional interaction, compliant, collaborative, confirmatory, and consumerist, which reflect the nature of the discourse between consumer and professiona

Patients, Professionals and the Internet: Renegotiating the Healthcare Encounter

The aim of this research was to examine how patient use of internet information impinges on the utilisation of healthcare services. The research had the following objectives: + to quantify the extent, and patterns, of patients use of the internet as a health information resource and identify the factors leading to variations in behaviour. + to identify the search strategies employed by patients in accessing internet health information internet and the evaluative approaches used in assessing information quality. + to analyse the content and dynamics of virtual health communities and how participation in such communities is integrated into engagement with health services. + to document the evolving nature of patient-professional interaction arising from patient access to health information and the subsequent format of the healthcare encounter. + to assess the effect of changing patient access to information and changes in the healthcare encounter on patterns of patient decision making and health behaviours

Health communities as permissible space: supporting negotiation to balance asymmetries

Online communities provide promising opportunities to support patient–professional negotiations that address the asymmetries characterizing health services. This study addresses the lack of in-depth understanding of these negotiations, what constitutes successful negotiation outcomes, and the potential impact of negotiation on offline health behaviors. Adopting a netnographic approach, two threads were observed from each of the four online health communities focusing on breast cancer, prostate cancer, depression, and diabetes, respectively. This analysis was supplemented with 45 in-depth interviews. The evidence suggests that online health communities can be constructed as permissible spaces. Such virtual spaces facilitate the type of patient–professional negotiations that can redress asymmetries. The critical elements of the negotiation process are identified as occupation, validation, advocacy, and recording. These support patients and professionals as they debate and resolve conflicts in how they experience health. Direct tangible offline negotiation outcomes are reported (e.g., changes in treatment plans). Implications for professional–patient partnerships are also explored