The Woman Patient

Abstract

Women have generally received their health care in settings that have been organized in a hierarchical model, with the physician dominating. The expectation that the doctor, who has usually been male, is informed, helping, authoritative, and protective conforms with the conventional social role of women, who have been seen as compliant, accommodating, and less well informed. This emphasizes the “childlike” position of the woman patient with respect to the “parent” physician. Indeed, in many instances, decisions about a patient’s care have been, and still are, based on a paternalistic view, that is, on the doctor’s understanding of the best interests of the patient. This is exemplified in decisions about female sterilization and abortion. Until recently, these decisions were made largely on the basis of the physician’s assessment of their necessity. Another example is that physician’s attitudes about a woman’s childbearing plans and potential have influenced recommendations for hysterectomy. Similarly, the physician with a woman patient who has breast cancer has found it difficult to empathize with her or to understand her views or decisions if they are different than his. Often if radical surgery is his choice, he has not given serious consideration to her wishes to retain her breasts.