How nonverbal communication sHapes doctor–patient relationsHip: From paternalism to tHe etHics oF care in oncology

Abstract

the purpose of this research, led in the wake of years of pressure to reject
paternalism, was to study whether controlled practice of nonverbal
communication by doctors inheres a continued risk of paternalistic attitudes in
oncology clinic interviews (chosen to illustrate the doctor–patient relationship).
this study involved qualitative descriptive research based on interview
observations and questionnaires and mobilized recognized theory borrowed from
sociology and anthropology. We found that the legislative framework governing
the doctor–patient relationship has simply shifted the paternalism issue from
verbal communication over to a new area that doctors have not yet mastered and
patients have not yet understood, i.e. nonverbal communication. this study
shows that all the laws framing the doctor–patient relationship can be
circumvented, and that by controlling nonverbal communication, the doctor can
fall back into paternalism. the rejection of paternalism therefore needs to lead
to an appropriate reading of the patient’s story, which in ethical terms can only
happen if hospital structures are made non-paternalizing by design, if doctors
learn to understand the patient’s different chronemic timeframe, and if doctors
committedly engage in the hippocratic Oath codified through the ethics of care.