Transition from paternalism to shared decision making – a review of the educational environment in Bosnia and Herzegovina and Croatia

Abstract

Transition from paternalistic to partner relation between physicians and patients is moving slowly ahead in Croatia and Bosnia and Herzegovina. Educational environment is improving but needs intense efforts to develop further.

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

“…In recent decades, the doctor–patient relationship has moved from a paternalism-based model to one that advocates respect for patient autonomy; however, this transition has not been uniform throughout the world. Countries have different cultural, historical and political determinants that can influence the speed and manner in which this transition occurs [ 39 ]. In addition, some professionals have doubts about the implementation of an autonomist model based on sharing decisions, saying that their patients do not want to participate in decision-making, do not have the capacity to participate or could even make poor decisions, and considering that consultations take time that they do not have [ 38 ].…”

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

“…In recent decades, the doctor-patient relationship has moved from a model based on paternalism to one that advocates respect for patient autonomy; however, this transition has not been uniform throughout the world. Countries have different cultural, historical and political determinants that can in uence the speed and manner in which this transition occurs [45]. In addition, some professionals have doubts about the implementation of an autonomist model based on sharing decisions, indicating that their patients do not want to participate in decision-making, do not have the capacity to participate or could even make bad decisions, and considering that consultations take time that they do not have [46].…”

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico.

“…In recent decades, the doctor-patient relationship has moved from a model based on paternalism to one that advocates respect for patient autonomy; however, this transition has not been uniform throughout the world. Countries have different cultural, historical and political determinants that can in uence the speed and manner in which this transition occurs [41]. In addition, some professionals have doubts about the implementation of an autonomist model based on sharing decisions, indicating that their patients do not want to participate in decision-making, do not have the capacity to participate or could even make bad decisions, and considering that consultations take time that they do not have [40].…”

“…in other words, the correspondence between what the healthcare professional knows about the situation and what the healthcare professional tells the parents (items 18, 19, 28, 31); c) Attitude towards death, which refers to healthcare professional's willingness to adapt, react and act in situations related to death (items 28,29,30,41,43,44,47,49); d) Family member with IDD or ASD, which asks whether any member of the professional's family has been diagnosed with IDD or ASD (item 13); e) Bioethics courses, which refers to courses related to medical ethics that the healthcare professional has taken throughout his/her professional training (item 16); and f) Religion, which refers to whether the professional describes him/herself as a believer or nonbeliever regarding religion (item 53). To construct the communication pattern, value assigned to the truth and attitude towards death indicators, we followed the same methodology that was used for the paternalism indicator.…”