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May 25, 2011

Are Patients Knights, Knaves, or Pawns?

Author Affiliations

Author Affiliations: Centers for Medicare & Medicaid Services, Washington, DC (Dr Jain); and AARP, Washington, DC (Mr Rother).

JAMA. 2011;305(20):2112-2113. doi:10.1001/jama.2011.694

British sociologist Julian Le Grand has noted that public policy is grounded in a conception of humans as “knights,” “knaves,” or “pawns.”1 Human beings are motivated by virtue (knights) or self-interest (knaves) or are passive respondents to their circumstances (pawns). A society's view influences whether it builds public policies that are permissive, punitive, or prescriptive.

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