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How to reveal disguised paternalism: version 2.0.
Niels Lynøe1, Ingemar Engström2, Niklas Juth3
1Centre for Healthcare Ethics, Karolinska Institute, 171 77, Stockholm, Sweden. niels.lynoe@ki.se.
BMC Medical Ethics
|December 28, 2021
Summary
Researchers refined an index to detect disguised paternalism, where physicians may question patient competence to influence end-of-life decisions. The 2020 study revealed specific physician groups exhibit this, contrasting with earlier findings.
Area of Science:
- Medical Ethics
- Palliative Care Research
- Health Policy Analysis
Background:
- Disguised paternalism can impact physician assessments of patient decision-making competence, particularly in end-of-life care.
- This phenomenon occurs when physicians mask hard paternalism as soft paternalism by challenging a patient's competence.
Purpose of the Study:
- To further develop and refine an index for detecting disguised paternalism in medical practice.
- To compare physician attitudes and disguised paternalism indicators between 2007 and 2020.
Main Methods:
- An existing index for disguised paternalism was further developed using data from cross-sectional studies.
- Results from a 2007 study were recalculated and compared with a new study conducted in 2020.
- Both studies focused on physicians' attitudes towards physician-assisted suicide.
Main Results:
- The 2020 study indicated disguised paternalism in geriatricians, palliativists, and middle-aged physicians (46-60 years).
- This contrasts with the 2007 study, where most specialties (except GPs and surgeons) showed high disguised paternalism.
- The index successfully differentiated degrees of disguised paternalism across groups and time.
Conclusions:
- The developed index reflects group attitudes towards physician-assisted suicide and allows for comparisons across specialties and age groups.
- Identifying disguised paternalism is crucial due to its potential to infringe on competent patients' decision-making rights.
- Further development of methods to measure disguised paternalism is warranted.
Keywords:
Disguised paternalismHard and soft paternalismPhysician assisted suicideValue impregnated factual claimsMore Related Videos
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