Paternal and Protective Clinic Practices-Reply

In Reply.—We believe that Dr McGraw misunderstands our basic thesis. Our concern is with clinic practices that create in parents and children an unnecessary degree of dependency upon health professionals. The focus is situations in which clients are able to assume responsibility for aspects of their own care that, nevertheless, caregivers relegate to themselves. As we argued, such gratuitous dependency fails to respect the ability of persons to carry on their own life activities and does not contribute to their long-term well-being. Nevertheless, we clearly recognize that circumstances exist in which persons are not able to assume greater self-reliance in attending to their health care needs. The extent of these circumstances will vary greatly with the socioeconomic characteristics of the particular clinic population.

This restatement of our thesis allows us to address some of Dr McGraw's particular concerns. First, we agree that in some clinics paternal and protective practices