Thanks for the article you posted, David. I think the paternalism of the past is being chipped away at, but I still see it every day with even the female physicians who care for laboring women ( I guess that was a mistaken assumption on my part, that women doctors would tend to be less paternalistic.) I have to be very careful as a nurse to recognize that the patient has the right to decide how she wants to be treated, and my ministrations, however well-intentioned, must take second place to her wishes. I try very hard to give the patient all of the available information at my disposal, offer her choices, make sure she is aware of the potential consequences, and then listen carefully when she tells me what she wants. I work to accomplish that within the scope of my responsibilities as a nurse (i.e., there's some stuff I just have to do or endanger the patient, lose my license, etc.). But I make sure the patient has the choice to the best of my ability. What her doctor does is not up to me. Unfortunately, I have seen the doctors just decide for the patient what is "best". How do they measure that without finding out what the patient really wants? These docs (the ones I work with ) are so busy I am not surprised at some of their attitudes. Unfortunately, paternalism saves time.

__________________
Jan Grossberg, RN, BSN
Editorial Team