Paternalism in Health Care

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Paternalism is basically defined as decisions taken on behalf of the patient by health care providers without the patient's consent from the position that the health care provider knows best.

Provider-patient relationships today are no longer as paternalistic as in the past. Patients have far greater access today to information about their rights, and much information is available on the internet and electronically in regard to health topics.

I personally find some providers still cling to the old authority models, and I find this stressful when I am a patient. Examples are: not being listened to when I raise a valid concern about my health care, and having my wishes disregarded when they are appropriate. For example, I once went for a specialty procedure, and when the person who was going to perform the procedure read off incorrect information about the part of my body that was going to undergo procedure, I corrected them, and they then corrected their information, and I said I would inform the specialist. I informed the specialist promptly, expecting that this important information would be received well; however, I received a very defensive message in return.

On another occasion I attempted to address and correct incorrect information in my medical record. I first requested and attempted a discussion of this situation with the appropriate parties; when due to genuine or disingenuous reasons I received an inadequate response, I took the first formal steps towards resolving the situation, which I think caused some surprise.

Paternalism in health care is one of the greatest stressors for me as a patient. There is a strong desire by some to continue to relate to patients in a paternalistic way, negating the intelligence, views, preferences, and autonomy of the patient, which is detrimental to provider-patient relationships. To preserve provider-patient relationships over the long term, failing to listen to patients and accord patients respect while imposing one's own views, damages the provider-patient relationship and can lead to it's breakdown.

There exists an attitude by some in health care, "I am right whether I am right or wrong." This can be described as arrogance, or imperiousness. I have found that in order to be effective when dealing with such behaviors as a patient and a family member, it is important to make sure one is acting within one's rights, and that one must remain firm, consistent, and reasonable when one receives inadequate responses. One's own conduct must remain respectful and appropriate throughout.

Down with paternalism. Male privilege has to be curbed!

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