The Paternalistic Model, also known as the Parental or Prietsly Model, strives to ensure that the patient receives the medical intervention that the physician considers best in the specific medical scenario.  In this model, physicians use their skills to determine the patients medical condition and identify the medical tests and treatment most likely to restore the patients health or alive their pain. Afterwards, the physician presents the patient with the selected information that will encourage the patient to consent to the intervention that the physician considers best. This is based on the idea that both the physician and patient have shared values for what treatment is the best in this situation. This model gives the physician more control over how the medical intervention will play out and considers it acceptable that the physician will most likely have the greater knowledge on how to ensure the patient’s health is benefitted.

Example: An individual has just been diagnosed with a treatable heart disease and has a wide range of options available to help treat their condition. The physician using the paternalistic model would then review these options and identify what medication they feel is best suited to help the patient recover. Instead of explaining all possible options, the physician would then tell the patient about the medication they feel is best suited to help them, and provide them with an explanation and evidence regarding the medication that supports their choice.

Pros:

• In emergency medical scenarios, it may be necessary for the physician to make the patient’s medical decisions if it is difficult to obtain informed consent from the patient due to their condition
• In many medical scenarios, the physician has both greater knowledge and experience than the patient on what medical interventions would work best in their situation. Giving the physician more control over leading the patient can help prevent the patient from being confused or overwhelmed.

Cons:

• In daily physician-patient interaction, it would be wrong to assume that both the patient and physician share the same beliefs and values which the paternalistic model assumes
• The physician may be unethically withholding information that would alter the decision making of the patient to help reach the conclusion that the physician considers best

 

References:

E. J. Emanuel and L. L. Emanuel. “Four Models of the Physician-Patient Relationship”. April 22, 1992. JAMA. https://medicinainternaucv.files.wordpress.com/2013/02/cuatro-modelos-de-relacic3b3n-m-p.pdf

“Provider-Patient Relationship”. University of Missouri, School of Medicine. https://medicine.missouri.edu/centers-institutes-labs/health-ethics/faq/provider-patient-relationship