Paternalism pertains to an action that an individual takes over the interest of another individual, resulting in the deprivation of one’s right to make his own personal decision. This concept takes its history from the perception that the father of the family always knows what is best for the members of his family. In the field of healthcare, paternalism involves the physician as the dominant and all-knowing individual who decides which procedures and treatments will be administered to a patient.
Healthcare professionals, especially physicians, are required to take the Oath of Hippocrates, which essentially states that one should do no harm to a patient. Unfortunately, this is not the general observation in relationships between a physician and a patient. Aside from the unequal responsibility of each party, the perception of physicians varies among different countries and continents. It should be understood that every patient should be given autonomy to make decisions with regards to healthcare procedures and treatments.
In cases wherein the patient is allowed to decide on what should be performed on not, the relationship between the physician and the patient is generally positive. On the other hand, when the physician actively chooses what is best for the patient, it is more likely that the patient will not follow most of the physician’s suggestions. As a healthcare professional, it is very important that autonomy is exercised in every interaction with a patient in order to prevent paternalism or misuse of power.
Autonomy historically pertains to the independence of Greek states from any form of control from outside forces such as the conqueror of another state. Autonomy also upholds the rights of a patient of rule, as well as to determine whether a certain treatment will be performed or not. However, it should be understood that before a patient makes a decision with regards to a particular procedure, the physician has to fully explain the medical condition that the patient is suffering from. It is important that the patient understands his illness, in order for him to assess the severity of his condition.
The physician should also enumerate all possible options of treatment for this particular disease, including the benefits and risks of every procedure. It will also be helpful that the physician translates the medical terms to simple layman’s words so that the patient gets the entire picture of his medical condition. Caution should also be exercised by the physician when he uses simple words to describe the condition because it may be possible that the entire image of the disease is distorted as the physician attempts to use layman’s words in explaining certain topics.
Paternalism and misuse of power can be avoided in the medical field by allowing a patient to freely decide on the specific course of treatment that will be administered (Deegan and Drake, 2006). The physician is responsible in explaining each treatment regimen to the patient yet should not influence the patient in any way as to which procedure should be chosen. The physician should also provide information to the patient regarding the effectiveness and sensitivity of each treatment.
Any side-effects and contraindications must also be disclosed by the physician to the patient. One of the prime indicators that paternalism does not exist in the medical profession is when a patient voluntarily submits himself to a certain medical treatment. When this occurs, it is most likely that no other individual coerced or influenced the patient into making that decision and thus it is also likely that the patient will adhere to the subsequent procedures that are associated with the treatment option.
Adherence has also been a recent topic of interest in the medical field. This pertains to the cooperation of the patient with regards to the suggested treatment for a particular disease. Adherence thus translates to the action of following most of the advice of the physician, such as cessation of smoking or avoiding fatty food. When a patient does not understand his medical condition, he will most likely not follow the physician’s advice because the patient does not see any relevance in what has been suggested to him.
For example, if the hypertensive patient does not understand the correlation between fatty food and high blood pressure, then it is probable that the patient will continue on with his lifestyle of consuming fatty foods. It is also possible that the physician did not fully explain to his patient that eating fatty food will significantly increase the glyceride levels in his serum. This condition will influence his systemic blood pressure to increase, resulting in greater chance of suffering from a myocardial infarct or a stroke.