Introduction: The terms autonomy and paternalism can be conceptualized and analyzed from different perspectives. The most relevant for physicians in this study are the ethical and legal viewpoints. In order to conceptualize anything a definition to depart from is needed, in this case from Oxford’s dictionaries. The importance to reflect on ethical and legal matters as a physician is due to the power over the patient one has, and it must be respected and grounded in a motivated ethical principle, since all our actions arise from ethics, consciously and subconsciously. Aim: The aim is to analyze and discuss the relationship between paternalism and autonomy from a medical ethical perspective, in relevant Swedish laws and with regards to the ethical principles. Methods: This is a qualitative study on hermeneutic ground that used two different databases and libraries and sorted material according to relevance. Inevitably this leads to a bias due to the author’s previous knowledge and selected sources. Results, Discussion and Conclusion: Physicians tend to prioritize ethical arguments depending on the situation. Autonomy is one of the four ethical principles, and this is not always the most prioritized, but beneficence may be seen as a stronger argument for action. Also, there are more regulations to secure the patient’s autonomy than the physician’s paternalism, leading to only indirect regulations towards paternalism. The conceptualization of paternalism and autonomy can be seen in many different ways, and are not always opposites as it can initially seem, but in some scenarios aline.

Bakgrund: Personcentrerad omvårdnad är något som läggs stor vikt vid i dagens sjukvård. I och med detta får sjuksköterskor större ansvar genom att sätta patienten i fokus. Traditionella överrapporteringar utförs utan patientens närvaro samtidigt som det finns en rapporteringsmetod som istället inkluderar patienten, vilket är bedsiderapportering. Bedsiderapportering är relativt nytt och forskning har främst undersökt sjuksköterskornas perspektiv. Dessutom är traditionella överrapporteringar inte i enlighet med de lagar som styr vården idag. Syfte: Syftet var att belysa patientens upplevelse av bedsiderapportering inom slutenvården. Metod: En litteraturstudie med 10 kvalitativa studier, som kvalitetsgranskades. Resultatanalysen gjordes med hjälp av en kvalitativ metod. Resultat: Generellt upplevde patienter en aktiv delaktighet samtidigt som önskan även framkom om mera delaktighet medan andra uppskattade en mer passiv roll. Språket som sjuksköterskor använde under överrapporteringen upplevdes som svårförståeligt. Bedsiderapportering möjliggjorde för patienter att få mer kunskap om sin vård och om sjuksköterskornas arbete. Patienter upplevde att sjuksköterskor skyddade deras integritet, samtidigt som andra patienter upplevde att sjuksköterskor inte uppmärksammade patienten som en person. Patienter förklarade att de kände sig mer trygga med sin vård då de visste att informationen från föregående sjuksköterska hade överlämnats till den kommande sjuksköterskan. Patienter upplevde att de behandlades som en person i första hand och en patient i andra hand. Slutsats: Eftersom patienter upplevde bedsiderapportering som inkluderande så kan metoden för överrapportering mellan sjuksköterskor ses som ett alternativ till den traditionella för att vården ska vara uppdaterad i enlighet med Patientlagen. Patienter upplevde inte att integriteten var ett bekymmer, vilket tidigare forskning har spekulerat som problematiskt. Mera forskning behövs utifrån patientens upplevelse av bedsiderapportering då forskning saknas. / Background: Person-centered nursing is something that attaches great importance to today's healthcare. With this, nurses become more responsible by focusing on the patient. Traditional nursing handovers are performed without the patient's attendance while there is a reporting method that includes the patient, which is bedside nursing handover. Bedside nursing handover is relatively new and research has primarily examined the nurses' perspective. In addition, traditional nursing handover are not in accordance with the laws governing health care today. Aim: The aim was to illuminate the patient's experience of bedside nursing handover in the field of primary care. Method: A literature study with 10 qualitative studies was used, which was quality-reviewed. The results analysis was done using a qualitative method. Results: Generally, the patients experienced active participation, while also wishing to see more involvement while others appreciated a more passive role. The language that nurses used during the handover were perceived as difficult to understand. Bedside nursing handover enabled patients to gain more knowledge about their care and the nurses' work. Patients perceived that nurses protected their privacy while other patients experienced that nurses did not pay attention to the patient as a person. Patients explained that they felt more secure with their care as they knew that the information from the previous nurse had been handed over to the oncoming nurse. Patients felt that they were treated as a person primarily and a patient secondly. Conclusion: Since patients experienced bedside nursing handover as inclusive, the method of handover between nurses can be seen as an alternative to the traditional nursing handover in care since it is updated in accordance with the Patient Act. Patients did not experience integrity as a concern, as previous research has speculated as problematic. More research on the patient's experience of bedside nursing handover is needed as research is lacking.

In this thesis, a phenomenological approach is taken as the purpose is to discuss how the healthcare experiences of Swedish patients with chronic illness are affected by political state reforms and governing technologies. The thesis compares the discourse of Swedish healthcare policy with the discourse of healthcare in practice. Swedish healthcare has gone through major changes during the past decades, which have affected the state-to-patient relationship. This shift involved a transfer of responsibility from the state to its citizens, enabled through patient empowerment. In this change, a new ideal patient-role emerged, which is the patient as an informed and active consumer. What this thesis shows is the existence of a discrepancy between the ideal patient-role in governmental writing and the same ideal patient-role in the reality of the healthcare system. The ethnography consists of a literature study of healthcare policy documents and interviews with ten informants about their experiences of healthcare, in connection with the chronic diseases that affected their lives. The aim has been to examine the governing qualities of healthcare policy and practice, implementing Foucault’s theory of governmentality and technologies of the self.