Cultural diversity matters

Editor—To investigate whether patients are partners¹ in Russia we recently conducted a small study of patients in hospitals of a provincial town. Although half of the patients knew their right to participate in decisions and to give consent, only a third wanted to know all the details about the course of their disease and their prospects of treatment.

Only a third had read about their chronic conditions in medical or lay texts, and half had only the information that they had been given by their physician or nurse. About a quarter wanted their physician to take responsibility for all the decisions. Income, age, and education of patients did not influence these proportions significantly.

I think that cultural differences enormously affect patients’ acceptance of the partnership relationship. Cultural diversity may occur in many national or religious groups in every country. Russia is a special example: orthodox paternalistic style is still alive in Russian medicine despite legislation regulating health care since 1993. This is understandable because the state has been all powerful here since 1917. I believe that people must be treated in the way that suits them best.