Medical gaslighting as a threat to beneficence and patient autonomy: a qualitative study

医疗煤气灯效应对行善和患者自主权的威胁:一项定性研究

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Abstract

BACKGROUND: Medical gaslighting- a phenomenon where healthcare professionals dismiss or minimize patients' symptoms- has garnered increasing attention due to its potential to cause significant harm to patients. This study aims to examine the ethical ramifications and implications of medical gaslighting, and explore how patients interpret and experience interactions affected by medical gaslighting. METHODS: We conducted two narrative interviews with fourteen participants. The first interview was conducted 2-3 days after discharge from hospitalization, and the second was carried out a month later. We then interpreted their stories through bioethical lenses. RESULTS: Data analysis yielded two main themes: (1) Pain dismissal and minimization; (2) Delayed or missed diagnoses- as subjectively perceived by interviewees. Using a principlist approach, we argue that medical gaslighting constitutes an obstacle to respect for patient autonomy and jeopardizes proper actualization of beneficence. Participants frequently described feeling dismissed, especially when presenting with complex or non-visible symptoms. CONCLUSIONS: Medical gaslighting appears to be a common and impactful experience that contributes to psychological distress and reduces trust in the medical system, potentially delaying diagnosis and treatment. Healthcare institutions must prioritize training on implicit bias, communication skills, and patient-centered care to mitigate these harmful interactions. Future research should further explore structural contributors and develop interventions to foster more validating clinical environments. We propose some practical implications for eradicating medical gaslighting based on our findings.

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