Dev World Bioeth. 2023 Sep;23(3):260-268. doi: 10.1111/dewb.12355. Epub 2022 May 19.
Medical paternalism has long been a common medical practice. However, patient autonomy in healthcare has been recently adopted by doctors and patients alike. This study explored whether doctors and patients in a tertiary care hospital in Saudi Arabia preferred autonomy or paternalism in shared decision-making. A total of 118 participants (51 patients requiring total knee replacement, owing to stages 3-4 of osteoarthritis, and 67 doctors) from the Eastern province, Saudi Arabia. responded to a 17-question category-based questionnaire involving four scales of autonomy. Descriptive statistics and chi-square test results revealed that in this hospital, patients preferred a paternalistic approach toward their medical care along with a full disclosure of the risks related to surgical procedures. We recommend health education regarding the specific autonomy subscales (doctor knows best, patient should decide, right to non-participation, and obligatory risk information), and the implementation of protocols that protect patients' rights and enhance personal autonomy.
医学家长主义长期以来一直是一种常见的医疗实践。然而，医疗保健中的患者自主权最近已被医生和患者共同采用。本研究探讨了沙特阿拉伯一家三级保健医院的医生和患者在共同决策中更倾向于自主权还是家长主义。共有来自沙特阿拉伯东部省的 118 名参与者（51 名因 3-4 期骨关节炎而需要进行全膝关节置换术的患者和 67 名医生）对涉及四个自主权量表的 17 个基于问题类别的问卷做出了回应。描述性统计和卡方检验结果表明，在这家医院，患者更倾向于接受家长式的医疗护理，并充分了解与手术相关的风险。我们建议开展有关特定自主权子量表（医生最了解、患者应决定、不参与的权利和强制性风险信息）的健康教育，并实施保护患者权利和增强个人自主权的协议。
