Abstract：
The present study aims to explore the forms paternalistic communication can take in doctor-patient interactions and how they should be considered from a normative perspective. In contemporary philosophical debate, the problem with paternalism is often perceived as either undermining autonomy (the autonomy problem) or the paternalist viewing their judgment as superior (the superiority problem). In either case, paternalism is problematized mainly in a general, theoretical sense. In contrast, this paper investigates specific doctor-patient encounters, revealing distinct types of paternalistic communication. For this study, I reviewed videorecorded encounters from a Norwegian hospital to detect paternalism-specifically, doctors overriding patients\' expressed preferences, presumably to benefit or protect the patients. I identified variations in paternalistic communication styles-termed paternalist modes-which I categorized into four types: the fighter, the advocate, the sympathizer, and the fisher. Drawing on these findings, I aim to nuance the debate on paternalism. Specifically, I argue that each paternalist mode carries its own normative implications and that the autonomy and the superiority problems manifest differently across the modes. Furthermore, by illustrating paternalism in communication through real-life cases, I aim to reach a more comprehensive understanding of what we mean by paternalistic doctors.
摘要：
本研究旨在探索家长式沟通在医患互动中可以采取的形式，以及如何从规范的角度考虑。在当代哲学辩论中，家长制的问题通常被认为是破坏自主性(自主性问题)，或者家长制主义者认为他们的判断是优越的(优越性问题)。无论哪种情况,家长制主要是在一个普遍的问题上，理论意义。相比之下,本文调查了特定的医患关系，揭示了不同类型的家长式交流。对于这项研究，我回顾了挪威一家医院的视频记录，以检测家长式，特别是，医生凌驾于患者的表达偏好之上，可能是为了造福或保护患者。我确定了家长式沟通风格的变化-称为家长式模式-我将其分为四种类型：战斗机，倡导者,同情者,还有那个渔夫.根据这些发现，我的目的是细微差别关于家长制的辩论。具体来说,我认为，每种家长式主义模式都具有自己的规范含义，并且在各种模式中，自主性和优越性问题的表现不同。此外，通过现实生活中的案例来说明沟通中的家长制，我的目标是更全面地理解我们所说的家长式医生的意思。
