The Right Kind of Paternalism

The practice of medicine has entered a new phase of patient "consumerism" and has, fortunately, emerged from the days of strict physician paternalism; this welcome trend places new emphasis on the role of patients in decision making and the right of patients to refuse various diagnostic and therapeutic procedures.

Abstract

While welcoming the new emphasis on informed consent and the right of\npatients to refuse treatment, the author warns that at times patients'\nemotional responses to their illnesses may compromise their decision making\nabilities. He describes several situations where a patient's refusal of a\ndiagnostic or therapeutic procedure might stem from denial, guilt, fear,\nmisplaced anger, or depression, rather than from comprehension of the risks\nand benefits involved. Marzuk cautions his fellow physicians against\ndiscarding all remnants of paternalism in the face of legal pressures or fears\nof violating patient autonomy. The right kind of paternalism guards patients\nagainst the consequences of ill-conceived decisions based on emotion rather\nthan understanding. (KIE abstract)