BMJ 1999;319:719-720 ( 18 September )

Editorials

Paternalism or partnership?

Patients have grown upand there's no going back

The first 150 words of the full text of this article appear below.

Paternalism is endemic in the NHS. Benign and well intentioned it may be, but it has the effect of creating and maintaining an unhealthy dependency which is out of step with other currents in society. Assumptions that doctor (or nurse) knows best, making decisions on behalf of patients without involving them and feeling threatened when patients have access to alternative sources of medical informationthese signs of paternalism should have no place in modern health care. The articles assembled in this issue of the BMJ consider the scope for creating meaningful partnerships between doctors and patients and between health policymakers and local communities.

Partners work together to achieve common goals. Their relationship is based on mutual respect for each other's skills and competencies and recognition of the advantages of combining these resources to achieve beneficial outcomes. Successful partnerships are non-hierarchical and the partners share decision making and responsibility. The key . . . [Full text of this article]

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Relevant Articles

Two decision aids for mode of delivery among women with previous caesarean section: randomised controlled trial

Alan A Montgomery, Clare L Emmett, Tom Fahey, Claire Jones, Ian Ricketts, Roshni R Patel, Tim J Peters, Deirdre J Murphy DiAMOND Study Group
BMJ 2007 334: 1305. [Abstract] [Full Text] [PDF]

How effective are expert patient (lay led) education programmes for chronic disease?

Chris Griffiths, Gill Foster, Jean Ramsay, Sandra Eldridge, and Stephanie Taylor
BMJ 2007 334: 1254-1256. [Extract] [Full Text] [PDF]

Partnership with patients

Otto P Bleker, Philip Crowley, Chris Drinkwater, Rex Haigh, Ramy Daoud, J S Hopkins, Alan R Watson, David Syme, and Robert Fleetcroft
BMJ 2000 320: 117. [Extract] [Full Text] [PDF]

Take your partners for the dance
BMJ 1999 319: 0. [Full Text] [PDF]

Take your partners for the dance
BMJ 1999 319: 0. [Full Text] [PDF]

Decision aids for patients facing health treatment or screening decisions: systematic review

Annette M O'Connor, Alaa Rostom, Valerie Fiset, Jacqueline Tetroe, Vikki Entwistle, Hilary Llewellyn-Thomas, Margaret Holmes-Rovner, Michael Barry, and Jean Jones
BMJ 1999 319: 731-734. [Abstract] [Full Text] [PDF]

Quality at general practice consultations: cross sectional survey

John G R Howie, David J Heaney, Margaret Maxwell, Jeremy J Walker, George K Freeman, and Harbinder Rai
BMJ 1999 319: 738-743. [Abstract] [Full Text] [PDF]

Towards a feasible model for shared decision making: focus group study with general practice registrars

Glyn Elwyn, Adrian Edwards, Richard Gwyn, and Richard Grol
BMJ 1999 319: 753-756. [Abstract] [Full Text] [PDF]

Helping patients access high quality health information

Sasha Shepperd, Deborah Charnock, and Bob Gann
BMJ 1999 319: 764-766. [Extract] [Full Text] [PDF]

Framework for teaching and learning informed shared decision making • Commentary: Competencies for informed shared decision making • Commentary: Proposals based on too many assumptions

Angela Towle, William Godolphin, Trisha Greenhalgh, and Jeremy Gambrill
BMJ 1999 319: 766-771. [Extract] [Full Text] [PDF]

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Rapid Responses:

Read all Rapid Responses

Partnership in service planning

Hilary Curtis
bmj.com, 17 Sep 1999 [Full text]

First things first

Garrett R FitzGerald
bmj.com, 17 Sep 1999 [Full text]

Roots of anti-paternalism

Rex Haigh
bmj.com, 19 Sep 1999 [Full text]

Reconciling the two perspectives is the challenge of a mature partnership

J Hopkins
bmj.com, 24 Sep 1999 [Full text]

It takes two to patronise/be patronised

Anton Obholzer
bmj.com, 24 Sep 1999 [Full text]

Patient partnership

Philip Crowley
bmj.com, 24 Sep 1999 [Full text]