How to reveal disguised paternalism

Area of Science:

• Medical Ethics
• Health Psychology
• Physician Behavior

Background:

• Physicians may not openly express paternalistic attitudes towards patient involvement in decision-making.
• Socially desirable responses can mask true physician paternalism in surveys.
• Physician-assisted suicide (PAS) attitudes can reveal underlying ethical stances.

Purpose of the Study:

• To develop and validate indexes to detect disguised physician paternalism.
• To assess physician attitudes regarding patient autonomy and paternalism in decision-making.
• To identify physician groups exhibiting varying levels of disguised paternalism.

Main Methods:

• Utilized data from a Swedish survey on physician attitudes towards physician-assisted suicide (PAS).
• Developed a disguised-paternalism index based on responses to arguments against PAS.
• Created an autonomy index based on responses to arguments for PAS.

Main Results:

• Female general practitioners (GPs), surgeons, and older male physicians showed the least paternalism.
• Female physicians displayed a range of autonomy-respecting and non-respecting attitudes.
• Female GPs and older male physicians demonstrated the least disguised paternalism.

Conclusions:

• Disguised paternalism among physicians can be identified using specific questionnaire indexes.
• The developed indexes offer a tool for improving the assessment of physician paternalism.
• Case-specific questions may enhance the detection of disguised paternalism in future research.