SocPop

Question 1

What are the 3 main types of patient-doctor relationships?

Answer 1

1. Paternalistic (doctor-led)
2. Shared (partnership)
3. Informed (patient-led)

Question 2

Describe the paternalistic model

Answer 2

• Doctor asks specififc questions
• Information largely from doctor to patient
• Doctor makes decision
• Doctor knows best

Question 3

Describe the shared model

Answer 3

• Two way exchange of information
• Each seen as having some limitations to their knowledge
• Reach decision together about best course of action/treatment
• If disagreement, process becomes one of negotiaiton

Question 4

Describe the informed model

Answer 4

• Doctor communicates all relevant information and treatment options with risks and benefits
• Patietnt is active and expects to make the decision
• Decision making is solely down to the patient

Question 5

Which ethical principle underlies the paternalistic model?

Answer 5

Beneficence (doing good)
Acting in a patient’s best interests
BUT how do we know what is in a person’s best interest
Requires dialogue and sharing of information, respect for person’s views/values

Question 6

Which ethical principle underlies the informed model?

Answer 6

Respect for autonomy

BUT this does not mean just giving information, information may reduce autonomy if given in overload

Question 7

Name some components/results of shared decision making

Answer 7

Facilitates autonomy
Shares responsibility
Includes patient and doctor perspective more explicitly 
Requires dialogue
More complex relationship

Question 8

Name 3 challenges of shared decision making

Answer 8

1. Patient access to information
2. Patient ability to process complex information
3. Communication difficulties

Question 9

Name 4 reasons why ICE is good

Answer 9

1. We can identify the patient’s agenda
2. We can address their agenda in addition to our own
3. Patients feel cared about and listened to
4. Patients feel you are addressing their problem

Question 10

Name 4 positive outcomes of shared decision making

Answer 10

1. Increased patient satisfaction
2. Improved adherence with medication
3. Reduced anxiety
4. Improved self-management of condtiions e.g. asthma and diabetes