| Tittel: | Doctors pushing patients : communicative paternalism and not-so-shared decision-making | | Signatur: | 2025/10 | | Ansvar: | Anniken Fleisje | | Forfatter: | Fleisje, Anniken  | | Utgitt: | Oslo : OsloMet – storbyuniversitetet. Senter for profesjonsstudier, 2023 | | Omfang: | 1 b. | | ISBN/ISSN: | 9788283645538 | | Emneord: | Beslutningstaking / Brukermedvirkning / Etikk / Helsepersonell / Helsepersonell-pasientrelasjoner / Kommunikasjon / Legerollen / Pasientrollen / Selvbestemmelse | | Stikkord: | Paternalisme | | Note: | Doktorgradsavhandling. | | Innhold: | Doctors’ paternalism means overriding patients’ autonomy or preferences with the intention of benefitting them - for example, through coercive treatment, lying about diagnoses to keep their hopes up, or compelling them to consent to procedures.
Over the past century, paternalistic practices by doctors have increasingly been deemed unacceptable, and many have instead embraced shared decision-making - an approach where doctor and patient collaborate to reach a decision.
Research question
In this thesis, I focus on paternalism in doctor-patient communication - that is, cases where the doctor tries to make the patient consent to one course of action, but where the patient prefers another. I call this form of paternalism communicative paternalism.
My discussion rests partly on philosophical and normative analyses, and partly on qualitative analyses of video-recorded doctor-patient encounters from a Norwegian hospital.
The thesis seeks to pinpoint what, exactly, doctors’ paternalism is; where the line falls between non-paternalism and paternalism; and why doctors’ paternalism is problematic. However, I also discuss whether paternalism actually is as bad as its reputation suggests, and - if doctors are going to be paternalistic - how they should go about it.
In addition to discussions on these topics, I propose a model for combining empirical data with conceptual and normative analyses, drawing on the field of empirical bioethics. The thesis consists of three articles. | | Eier: | HELSTILS |
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