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Relación clínica con el paciente : How Acceptable Is Paternalism? A Survey-Based Study of Clinician and Non-Clinici
Enviado por Biblio on 17/4/2018 7:04:00 (55 Lecturas)

Bailoor K, Valley T, Perumalswami C, Shuman AG, DeVries R, Zahuranec DB. How Acceptable Is Paternalism? A Survey-Based Study of Clinician and Non-Clinician Opinions on Paternalistic Decision Making. AJOB Empir Bioeth. 2018 Apr 9:1-27. doi: 10.1080/23294515.2018.1462273. [Epub ahead of print]

Disponible: https://www.ncbi.nlm.nih.gov/pubmed/29630457

Abstract

We conducted an empirical study to explore clinician and lay opinions on the acceptability of physician paternalism. Respondents read a vignette describing a patient with brain hemorrhage facing urgent surgery that would be life-saving but result in long-term severe disability. Cases were randomized to show either low or high surrogate distress and certain or uncertain prognosis, with respondents rating the acceptability of not offering brain surgery. Clinicians (N = 169) were more likely than non-clinicians (N = 649) to find the doctor withholding surgery acceptable (30.2% vs. 11.4%, p = <0.001). Among clinicians, the doctor withholding surgery was more acceptable when prognosis was certain to be poor (OR 2.04, 95% CI 1.04, 4.01). There was no effect of surrogate distress on clinician ratings. Responses among lay public were more variable. Given the differences in attitudes across clinicians and lay public, there is an ongoing need to engage stakeholders in the process of end-of-life decision-making.

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