Communicating Respect for Patients as Persons: A Qualitative Study
Keywords:Ethics, respect, qualitative, person-centeredness, communication, persons, patients
AbstractBackground: Respect for persons is regarded as an important value in medical ethics, and yet, there is little written in the bioethics or professionalism literature about what respect actually entails in day-to-day clinical practice. Objective: To describe respectful behaviors and attitudes from the patient’s perspective. Methods: We conducted in-depth semi-structured interviews with 29 adults who saw their primary care physician on a regular basis. This sample consisted of 15 women and 14 men; 19 were African American and 10 were white. Patients were asked to describe their ideas about respect and to provide examples that illustrated respect and disrespect on the part of the physician. Interviews were transcribed and coded to identify major themes for each interview and to link together related themes across all interviews. Results: Participants identified four definitions of respect: being treated ‘as a person’, being treated as an equal, being treated as the physician would want to be treated, and being cared about. Patients readily identified behaviors that they associated with respect. These included listening to and understanding the patient, being polite (e.g. greeting and addressing the patient by name), explaining things in a way he or she can understand, allowing patient input into the treatment plan, attending to privacy/modesty, spending enough time, and being thorough. Conclusions: Patients are aware of, and sensitive to, subtle verbal, behavioral, and attitudinal cues from the physician that are interpreted as conveying respect or disrespect, and these cues may strongly influence the medical encounter. Cultivating an attitude of respect for patients, and communicating that respect through specific behaviors, can help create a more patient-centered healthcare system that embodies the values of the people it serves.
. The International College of Person-Centered Medicine 2015 September 22;Available at: URL: http://personcenteredmedicine.org/index.html.
. Saha, S., Beach, M.C., Cooper, L.A. (2008). Patient centeredness, cultural competence and healthcare quality. J Natl Med Assoc 100(11):1275-1285.
. Duggan, P.S., Geller, G., Cooper, L.A., Beach, M.C. (2006). The moral nature of patient-centeredness: is it "just the right thing to do"? Patient Educ Couns;62(2):271-276.
. Beauchamp, T.L., Childress, J.F. (2001). Principles of Biomedical Ethics. 5th ed. New York: Oxford University Press.
. Macklin, R. (2003). Dignity is a useless concept. BMJ;327(7429):1419-1420.
. Beach, M.C., Duggan, P.S., Cassel, C.K., Geller, G. (2007). What does 'respect' mean? Exploring the moral obligation of health professionals to respect patients. J Gen Intern Med;22(5):692-695.
. Karnieli-Miller, O., Taylor, A.C., Cottingham, A.H., Inui, T.S., Vu, T.R., Frankel, R.M. (2010). Exploring the meaning of respect in medical student education: an analysis of student narratives. J Gen Intern Med ;25(12):1309-1314.
. Cooper, L.A., Roter, D.L., Carson, K.A. et al. (2011). A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. J Gen Intern Med;26(11):1297-1304.
. Cooper, L.A., Roter, D.L., Bone, L.R. et al. (2009). A randomized controlled trial of interventions to enhance patient-physician partnership, patient adherence and high blood pressure control among ethnic minorities and poor persons: study protocol NCT00123045. Implement Sci ;4:7.
. Beach, M.C., Roter, D.L., Wang, N.Y., Duggan, P.S., Cooper, L.A. (2006). Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Educ Couns;62(3):347-354.