How nonverbal communication sHapes doctor–patientrelationsHip: From paternalism to tHe etHics oF carein oncology

Abstract

The purpose of this research, led in the wake of years of pressure to rejectpaternalism, was to study whether controlled practice of nonverbalcommunication by doctors inheres a continued risk of paternalistic attitudes inoncology clinic interviews (chosen to illustrate the doctor–patient relationship).This study involved qualitative descriptive research based on interviewobservations and questionnaires and mobilized recognized theory borrowed fromsociology and anthropology. We found that the legislative framework governingthe doctor–patient relationship has simply shifted the paternalism issue verbal communication over to a new area that doctors have not yet mastered andpatients have not yet understood, i.e. nonverbal communication. This studyshows that all the laws framing the doctor–patient relationship can becircumvented, and that by controlling nonverbal communication, the doctor canfall back into paternalism. The rejection of paternalism therefore needs to leadto an appropriate reading of the patient’s story, which in ethical terms can onlyhappen if hospital structures are made non-paternalizing by design, if doctorslearn to understand the patient’s different chronemic timeframe, and if doctorscommittedly engage in the Hippocratic oath codified through the ethics of care