Paternalism in medicine refers to doctors making decisions for patients that override the patients' wishes. There are two types: strong paternalism intentionally overrides patients against their will, while weak paternalism assumes patients cannot understand information or that some information would burden them.
Justifications for paternalism include the vulnerability of sick patients, medical expertise, and preserving patients' confidence in their doctors. However, most medical decisions are not urgent and patients should have time to understand their conditions and state their preferences. While doctors have expertise, personal values also influence treatment decisions. Disclosure of uncertainty need not decrease effectiveness if done to involve patients in their care.
2. Definition - acting for the good of another person in a way that a parent might act for the good of their child.
3. Assumption - the person acting paternally is wiser, more knowledgeable and experienced than the person they act for and this justifies taking charge.
4. In Medicine, the assumption is that doctors are more experts then patients
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10. Paternalism creeps in when there is unilateral decision by doctors that the patient does not need to know or would be better off not knowing
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12. The desire to spare patients uncertainty and fear can lead to paternalism.
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14. Fact is: the answer depends on the values that patient puts on various factors e.g. dissatisfaction with present therapy, needs to remain at work, indignation to take risks and the waiting list for different therapies.
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16. Assumption: disclosure of uncertainty is a bad thing for patients, and that uncertainty decreases doctors effectiveness as healers.
