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Discourses of Influence and Autonomy in Physicians' Accounts of Treatment Decision Making for Depression

Bibliographic Data

ID4724105
AuthorsLinda M Mcmullen (0000-0002-7948-4778, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, corresponding author)
Year2012
Volume22
Issue2
Pages238-249
Publication date2012-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueQualitative Health Research (JOURNAL)
Journal identifiersISSN: 1049-7323 • E-ISSN: 1552-7557
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/1049732311420738
PMID21890713
OpenAlexW2152547686
LanguageEN
Citations received8
References cited31

Models of patient-physician decision making are typically framed on a continuum of discourses and practices ranging from patient autonomy to physician paternalism, with the middle ground being occupied by terms such as shared decision making. Critiques of these models center on the gulf between these idealized models and actual practice and on how context influences decision-making practices. In this article I focus on how 11 Canadian family physicians talked about patient-physician decision making in interviews about their diagnostic and treatment practices for depression. I adopt a discursive approach to analyzing extracts from these interviews, and show how these physicians constructed themselves as engaging in acts of professional judgment and persuasion, and patients as having the final say in decision making about treatment for depression. I argue that whether the intertwining of discourses of physician influence and patient autonomy is understood as a balance of power between physicians and patients is an open question

Autonomy · MEDLINE · Paternalism · Patient participation · Persuasion · Political science · Law · Mental Health and Patient Involvement · Mental Health and Psychiatry · Patient-Provider Communication in Healthcare · Psychology · Social Psychology

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Unique citing works8
Citations per year0,73
Citation span2015 - 2021 (7)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 8
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