The Platinum Rule in Healthcare: Why Good Intentions Are Not Enough

Most people are familiar with the Golden Rule: treat others as you would like to be treated. In healthcare, this principle is well intentioned but inadequate. Good intentions alone do not guarantee that care will feel respectful, supportive, or helpful to the person receiving it.

In a short and thought provoking editorial, palliative care psychiatrist Harvey Max Chochinov proposes a more appropriate alternative known as the Platinum Rule:

Treat others as they would want to be treated.

This subtle shift has important implications for patient experience, clinical communication, and dignity in healthcare.

The Platinum Rule for Healthcare: Do unto patients as they would want done unto themselves

Why the Golden Rule falls short in clinical care

Clinicians regularly act with empathy and professionalism. Yet many patients, particularly those living with persistent pain or long term health conditions, report feeling unheard or misunderstood.

The issue is not necessarily a lack of effort, time or compassion. Often care is shaped by the clinician’s own values, preferences, and assumptions rather than the patient’s.

This mismatch helps explain why dissatisfaction and distress can persist, even when care is technically competent and well intentioned.

The Platinum Rule and dignity-centred healthcare

The Platinum Rule places dignity at the centre of patient-centred care. It prioritises curiosity over assumption and active listening over projection. Practicing the Platinum Rule involves actively exploring what matters most to the person in front of you and how they define good care. It requires flexibility in communication and treatment, shared decision making and a willingness to adapt rather than defaulting to habitual ways of helping.

Why this matters in persistent pain and long-term conditions

People living with persistent pain often describe a shared experience of invisibility (Koesling & Bozzaro, 2021).

When decisions are made about patients without patients, pain has the potential to worsen as people often feel disempowered, unrecognised and isolated.

When people feel seen, understood and taken seriously, the stage is set for the relevant treatment to be far more effective.

Patient-centred care starts with how we listen

The Golden Rule centres the clinician’s perspective. The Platinum Rule centres the person receiving care.

In modern healthcare, particularly in the treatment of persistent pain and chronic illness, this distinction matters.

References

Chochinov H. M. (2022). The Platinum Rule: A New Standard for Person-Centered Care. Journal of palliative medicine, 25(6), 854–856. https://doi.org/10.1089/jpm.2022.0075

Koesling, D., & Bozzaro, C. (2021). Chronic pain patients' need for recognition and their current struggle. Medicine, health care, and philosophy, 24(4), 563–572. https://doi.org/10.1007/s11019-021-10040-5