RR #1- 4 Models

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Apr 3, 2024

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Ariel Hampton 01/11/2024 “Four Models of the Physician-Patient Relationship” (pgs. 136-145) L. Emanual and E. Emanual address certain circumstances in which certain models are most effective and most appropriate to use, but “Descriptively and prescriptively, we claim that the ideal physician-patient relationship is the deliberative model” (pg. 144). They seem to be advocating for a mutual relationship that balances health and patient autonomy. That being said, there should be an equilibrium between the ideals and standards that are provided by a physician and the patient’s right to choose their treatment. They address that the most common form of patient autonomy is the patient’s right to accept or refuse treatment, but in the deliberative model, “Freedom and control over medical decisions alone do not constitute patient autonomy” (pg.144). The deliberative model isolates the specific health-related values based on the circumstances of their health or the stage of their disease. While I agree that moral deliberation is one of the crucial links between patient autonomy and health, I have to disagree with this being the most effective model to use in healthcare. I favor the Informative Model because I think it allows for the most freedom of the patient’s choices. To my understanding, the physician is offering the patient several options along with all relevant information necessary to proceed with medical interventions. It seems that the only difference between the informative and deliberative models is moral deliberation which I think is a form of coercion. The authors specifically say, “At the extreme, the physician and patient engage in deliberation about what kind of health-related values the patient could and ultimately should pursue….he or she recognizes that many elements of morality are unrelated to the
patient’s disease or treatment…”(pg.138). This leaves a huge gap for paternalism. Now the physician has the opportunity to insert not only his medical opinion, but his own goals are driven by what he believes is the best course of action. This may lead to the patient making a choice that the physician heavily influences. This is called an appeal to authority as the discussion between the patient and physician has reached outside of their clinical relationship.
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