Autonomy vs Paternalism in Healthcare

Is it Paternalism or Autonomy that will result in the best of medical outcomes? All to frequently, the medical provider uses medical lingo that leaves the patient and family wondering what was just told to them. The provider may also present the plan of care from a paternalistic approach ultimately making the decision for the patient. The patient may feel helpless and possibly lacking hope for their prognosis.
The approach that medical providers and healthcare workers practice sometimes leaves patients lacking the information they need to make informed decisions about the treatment plan and options that may be available to them. The paternalistic system that healthcare providers practice to manage an individual’s medical disease may sometimes present in the same manner of a father dealing benevolently and often intrusively with his children.
Does this practice affect the autonomy of our patients? Autonomy may be defined as the right to make decisions about one’s healthcare. The question arises about the practice of paternalism impacting the patient’s right of autonomy. Patients’ have the right to exercise their autonomy through self-determination. As a nurse, our ethical commitment is to abide by a patient’s right to determine his/her own health care. Complimentary to Autonomy is beneficence. This intertwining concept means, “to do good” for patients.
It is important that we are aware that 20% of the US Americans are functionally illiterate, with some regions rising as high as 40%, this may account for the practice of paternalism by healthcare workers. Therefore the practice of healthcare providers directing the patient’s care is mostly accepted with little expectation for discussion, explanation or challenge from the patient. Is this why paternalism is such a large part of the healthcare profession?
These ethical values come into play every day healthcare workers provide care for patients. The importance of informing patients about their medical health and their options for care are just one way to forge a patient’s autonomy. It is not a matter of “dumbing down” the information, but through support, guidance, and repetition; patients are empowered to make their own decisions for achieving medical health and wellness.
If our ethical values train us to do good for our patients, what better way to do good but by giving our patients the knowledge to make their own decisions about their healthcare? Nurses are in the position to educate the patient. Through the nursing role of advocacy, the legal rights and the ethical concerns of patients are addressed. Advocate Angels is a Personal Medical Advocate resource service. An Independent Registered Nurse works for the patient, empowering the patient and their family/caregivers through education and ongoing support to promote independence in their health and wellness initiative.
Please share with me your thoughts and ideas about Autonomy and Paternalism and its impact on Healthcare today.
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Advocate Angels a Personal Medical Advocacy Service

Posted in Medical Health and WEllness | 5 Comments