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- This is part of the wider ambition to promote patient centred care, to increase patient choice, autonomy and involvement in clinical decision-making and make no decision about me, without me a reality. ScienceDirect is the world's leading source for scientific, technical, and medical research. Plore journals, books and articles. Many people talk about the decline of the work ethic. Reality, it is not the work ethic which has declined. Ther, it is leaders who have failed.
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