Who is empowered in e-health?

‘Jakob Nielsen’s Digital Divide: The Three Stages’ posted by Ismael Peña talking about Empowerment Divide and a conversation with him make me think about empowerment in health and the consequences of Internet in this topic.

Roma Harris and Tiffany Veinot wrote The Empowerment Model and Using E-Health to Distribute Information. In this working paper they tackle the issue of empowerment: definition, the social context of ‘Patient Empowerment, and the most interested part for me the critical perspectives on ‘patient empowerment’

The idea of ‘patient empowerment’ is based on underlying assumptions that bear further examination. These include the ideas that:

• patients want to be in control of their health and health care;
• it is good for patients to have choice and control;
• health care providers support patient effors to gain control;
• providing health information to patients ’empowers’ them; and
• ‘informed’ and ’empowered’ patients take better care of their health

In summary the authors raise the Patient Empowerment Paradox.

I think this paradox is also related with the problems of the importance of expert system in modern society explained by Giddens and the critique of information made by Lash. Taking into account those authors I wonder if Does Internet empower patients? physicians? hospital managers? politicians? and is there a rivality among agents for empowerment? (“more empowered ones implies less empowered others”)