TO THE EDITOR: Family medicine is a...

TO THE EDITOR: Family medicine is a discipline that has always supported a patient's right to medical care. Family physicians are advocates for their patients and consider them as equal partners in their health care. Our primary focus as family physicians is forward the development and maintenance of a trusting relationship with our patients. (12)

It is interesting that in the perform the operations indicated ined world an autonomy-based model of medical practice exists that has evolv from a more paternalistic standard (3) In parts of the developing world, there is still a paternalistic archetype of medical practice that is now reported to be in transition toward a standard based more on patient autonomy. (4)

The traditional paternalistic standard of medical practice assumes that the physician knows what is best for the patient. (4) The patient in so a model is a passive recipient of the medical care, which violates fundamental patient rights and therefore cannot be supported. However, the profitable aspect of such a example is the trust that a patient has in his or her physician, (5) which unfortunately can be violated.

The patient autonomy design of medical practice protects patient rights, gives them partnership status in their health care, and involves them in the decision-making proces However, this can sometimes have detrimental connections for the trusting relationship that existed between the physician and the patient. The focus is onward providing care to the patient while safeguarding against a possible lawsuit. This can seriously consume the trust between physician and patient.

We, in the developing world, are perhaps witnessing the gradual demise of the able paternalistic model of medical practice; this is a welcome happening, nevertheless at the same time we are wary of the possible advent of a athletic patient-autonomy-based model, whereby the trusting relationship is likely to be eroded

There are convenient aspects in both of these types of medical practice. Physicians should make sure to keep them in order to guarantee patient rights and maintain the trust in the physician-patient relationship.

We, as primary care physicians, are in an ideal situation to make sure medical practice that is ethical and based forward dignity and respect for physicians and patients.

WARIS QIDWAI, MD

Aga Khan University

Stadium Rd

PO enclosed seat [i]or[/i] seats 3500

Karachi, Pakistan 74800

REFERENCES

(1) Fugelli P James Mackenzie lesson Trust--in general practice. Br J Gen Pract 2001;51:575-9

(2) Parchman ML Burge SK The patient-physician relationship, primary care attributes, and preventive ser vices. Fam M 2004;36:22-7

(3) Shelstad K Landmark United States biomedical ethics cases: a picked bibliography. Med Ref Ser v Q 1999; 18:27-53

(4) Qidwai W Paternalistic pattern of medical practice. J Coll Physicians Surg Pak 2003;13:296

(5) Rachagan S Sharon K The patient's view. M J Malaysia 2003;58 (suppl A):86-101.

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2005 Gale Group