Cultural Differences in Patients' Preferences for Paternalism: Comparing Mexican and American Patients' Preferences for and Experiences with Physician Paternalism and Patient Autonomy.

Following up on previous research demonstrating the high level of care realized by a paternalistic Mexican physician, the present research further explored the hypothesis that there are cultural differences in preferences for and experiences with physician paternalism vs. patient autonomy in White American culture as compared with Mexican culture. In this research, we interviewed sixty (60) people including twenty (20) Mexican, twenty (20) Mexican American, and twenty (20) White American respondents. We asked these patients about their experiences with and attitudes towards paternalism and patient autonomy in healthcare interactions. With some caveats, our data showed strong support for both hypotheses while also suggesting a high level of care can be realized by paternalistic physicians when "paternalism" is understood in a cultural context. We close with a brief consideration of the implications of these findings.

Can Physicians Demonstrate High Quality Care Using Paternalistic Practices? A Case Study of Paternalism in Latino Physician-Patient Interactions.

We argue that patient autonomy is a cultural value specific to Western culture and that the autonomy focus in U.S. health care may produce negative patient outcomes for patients from other cultures. To this end, we present a case study of a Mexican physician's interactions with his patients and apply the method of discourse analysis to argue that (a) this physician's interactions are highly paternalistic, (b) there is an appreciation for this among his Latino patients and in the broader Latino community, and (c) this physician provides high-quality ethical care precisely because his paternalism communicates important ethical values such as familial intimacy, insistence, and care. We further propose that paternalism may produce better outcomes for Latino patients.