Veinticinco siglos de paternalismo, 25 años de autonomía: una aproximación histórica a los cambios en la relación clínica

In the last few years, the physician-patient relationship has undergone more profound changes than in the 25 previous centuries. Many factors have influenced the change from a paternalistic relationship to one that is more centered on respect for the autonomy of patients' decisions after they have been informed of the risks and benefits by the health professional. As with any complex process, this change of paradigm requires adaptation of the actors involved, and sometimes the reasons leading to the change may not be clear to patients or their physicians. The present reflection aims to describe a series of historical and sociocultural factors that explain some key elements in this change, which could facilitate acceptance of the new roles in the current physician-patient relationship.