Week 7 - Doctors & Patients

Question 1

What is the second duty of doctors?

Answer 1

The public

Question 2

What are the responsibilities of the professional codes of conduct?

Answer 2

-Duties
-Guidelines

Question 3

What does responsibilities to personal ethics code cause?

Answer 3

Conscientious objection

Question 4

What is the cooperative model?

Answer 4

• “a cooperative model of decision-making has replaced the
  authoritarian model that was characteristic of traditional
  medical paternalism” (WMA Medical Ethics Manual 2015)
• “Patient-centred or ‘whole person’ care takes account of
  individuals’ values and circumstances as well as aspects of their
  health. It involves tailoring treatment, where possible, to reflect
  the patient’s preferences.”

Question 5

What is paternalistic approach?

Answer 5

• the doctor conceptualised as a guardian
  (paternal hierarchical relationship)
• The doctor would make decisions often with
  little/no discussion with the patient
• Decisions made in the patient’s best
  interests from knowledge of the medical
  facts alone

Question 6

What is patient-centered approach?

Answer 6

• increasing recognition of the right of patients
  to make their own medical decisions
• takes account of patients’ health AND values
  and life circumstances [gathering info about
  patient lifestyle, family history, social life]
• involves tailoring treatment, where possible,
  to reflect the patient’s preferences

Question 7

What are the 4 models of doctor-patient relationship?

Answer 7

-Paternalistic = I decide for you
= doctor decides appropriate treatment and gives selective information to the patient
-Informative= I give you facts
= provides factual information and implements patient’s selected intervention
- Interpretative= I give you facts and help you find your preference
= provides information and interprets relevant patient values
- Deliberative = I tell you my preference as well
= provides information, take into account patient values and engages in dialogue on what course of action would be best

Question 8

Summarise paternalistic doctor-patient relationship

Answer 8

-Too narrow meaning of well-being or best interest of patient
-Patient suffers “illness”, but doctor treats “disease”
-fails to integrate both “scientific” and “social” concepts of disease
- x patient autonomy
-unequal power dynamics

Question 9

Summarise patient-centred doctor-patient relationship

Answer 9

-Holistic understanding of presenting a problem
-More accurate diagnosis
-Increased adherence
-patient rights and autonomy
-patient’s control and choice
-doctor-patient shared decision-making
-patient satisfaction
-morale and efficiency of healthcare providers

Question 10

What are the core components of patient-centered approach?

Answer 10

1. Communication
2. Partnership
3. Health promotion

Question 11

What is role modelling?

Answer 11

Role modelling occurs
whenever a student is able
to observe a clinical trainer
Training communicates
norms and values shared by
doctors