Communicating Respect for Patients as Persons: A Qualitative Study

Abstract

Background : 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.