Applying Maternalism in Life and Death Medical Decision Making

SESSION DESCRIPTION

This session introduces maternalism as a clinician-guided decision-making framework grounded in relational autonomy and informed non-dissent. Through three clinical cases, the presenter will demonstrate how palliative care teams can support patients and families through life and death decisions when the act of choosing itself becomes a source of suffering, while attending to power and equity with a relational frame.

OBJECTIVES

  1. Distinguish maternalism from paternalism by articulating how relational autonomy reframes clinician involvement as supporting rather than overriding patient autonomy.
  2. Apply the sequential elements of informed non-dissent, including relational assessment, medical update, clinician-guided plan, and space for dissent, to a clinical case involving conflicting patient values.
  3. Identify at least two safeguards necessary to prevent maternalism from becoming paternalism, including trauma-informed monitoring for implicit distress and equitable investment in relational engagement across patient populations.


FACULTY

Chris Onderdonk, MSW, LCSW, APHSW-C
Palliative Care Social Worker
UC San Diego Health, Doris A. Howell Palliative Care Teams

Kyle P. Edmonds, MD, FAAHPM
Professor, Department of Medicine, UC San Diego School of Medicine