1 Brigham Young University, Provo, Utah, USA.
Qual Health Res. 2018 Oct;28(12):1910-1922. doi: 10.1177/1049732318783696. Epub 2018 Jul 2.
We argue that patient autonomy is a cultural value specific to Western culture and that the autonomy focus in U.S. health care may produce negative patient outcomes for patients from other cultures. To this end, we present a case study of a Mexican physician's interactions with his patients and apply the method of discourse analysis to argue that (a) this physician's interactions are highly paternalistic, (b) there is an appreciation for this among his Latino patients and in the broader Latino community, and (c) this physician provides high-quality ethical care precisely because his paternalism communicates important ethical values such as familial intimacy, insistence, and care. We further propose that paternalism may produce better outcomes for Latino patients.
我们认为，患者自主性是一种特定于西方文化的文化价值观，而美国医疗保健中对自主性的关注可能会给来自其他文化的患者带来负面的结果。为此，我们提出了一个墨西哥医生与他的患者互动的案例研究，并应用话语分析方法来论证：(a) 这位医生的互动是高度家长式的；(b) 他的拉丁裔患者和更广泛的拉丁裔社区对此表示赞赏；(c) 这位医生提供高质量的伦理护理，正是因为他的家长主义传达了重要的伦理价值观，如家庭亲密、坚持和关怀。我们进一步提出，家长主义可能会为拉丁裔患者带来更好的结果。
