explain the 4 models of doctor-patient interaction discussed in the Emmanuel & Emmanuel paper.

Briefly explain the 4 models of doctor-patient interaction discussed in the Emmanuel & Emmanuel paper. Which model do the authors defend as an ideal framework for healthcare practice? What are their reasons for thinking this, according to the paper? Do you think that their preferred model violates patient autonomy, why or why not?
Consider “Case 2”, at the end of Chapter 4 (Vaughn, 179): What options might the researcher have? what bioethical principles are in conflict, in this case? What do you think the researcher should do? Suppose there’s a law dictating that patients’ HIV status should never be disclosed: does that change your answer? Why or why not?
ANSWER
**Four Models of Doctor-Patient Interaction**
**The Paternalistic Model:** The physician knows best and makes all decisions about the patient’s care, without input from the patient.
**The Informative Model:** The physician provides the patient with all relevant information about their condition and treatment options, and then the patient makes the decision about their care.
**The Shared Decision-Making Model:** The physician and patient work together to make decisions about the patient’s care, based on the patient’s values and preferences.
**The Deliberative Model:** The physician and patient engage in a dialogue about the patient’s condition and treatment options, and then the patient makes a decision about their care based on their own reasoning and deliberation.
**Emmanuel and Emmanuel’s Preferred Model**
Emmanuel and Emmanuel defend the shared decision-making model as the ideal framework for healthcare practice. They argue that this model respects patient autonomy and allows patients to make informed decisions about their care.
**Reasons for Their Preference**
Emmanuel and Emmanuel argue that the shared decision-making model is the best way to respect patient autonomy. They believe that patients have the right to be involved in decisions about their own care and that they should be given the information they need to make informed decisions.
**Violation of Patient Autonomy**
Some people argue that the shared decision-making model can violate patient autonomy. They argue that patients may not be able to understand all of the information they are given, and that they may be influenced by the physician’s recommendations.
However, Emmanuel and Emmanuel argue that the shared decision-making model is the best way to protect patient autonomy. They believe that patients should be given the information they need to make informed decisions, and that they should be able to ask questions and get clarification from their physician.
**Case 2**
**Options for the Researcher**
The researcher in Case 2 has a number of options. They could:
* Disclose the patient’s HIV status to the patient’s spouse.
* Keep the patient’s HIV status confidential and counsel the patient on how to disclose their status to their spouse.
* Seek legal advice on their options.
**Bioethical Principles in Conflict**
The following bioethical principles are in conflict in this case:
* **Autonomy:** The patient has the right to make decisions about their own care, including the decision of whether or not to disclose their HIV status to their spouse.
* **Beneficence:** The researcher has a duty to do what is best for the patient, which may include disclosing the patient’s HIV status to their spouse.
* **Non-maleficence:** The researcher has a duty to avoid harming the patient, which could include disclosing the patient’s HIV status to their spouse if the spouse is likely to react violently.
**What the Researcher Should Do**
The researcher should carefully consider all of their options and weigh the potential risks and benefits of each option. They should also consider the patient’s wishes and values.
If the researcher believes that the patient would want their spouse to know about their HIV status, then they should disclose the patient’s status to the spouse. However, if the researcher believes that the patient would not want their spouse to know about their HIV status, then they should keep the patient’s status confidential.
**Law Dictating Confidentiality**
If there is a law dictating that patients’ HIV status should never be disclosed, then the researcher’s options are more limited. They could still counsel the patient on how to disclose their status to their spouse, but they would not be able to disclose the patient’s status themselves.
The researcher could also try to get the law changed, arguing that it violates patient autonomy.
Ultimately, the researcher must make a decision that they believe is in the best interests of the patient, even if it means breaking the law.