In his essay, “The Refutation of Medical Paternalism,” Alan Goldman discusses his argument against differentiation in the roles between physicians and patients. He says the physician may act against a patient’s will in order treat the patient in their best interest. Goldman makes his whole argument around the assumption that a person’s right to decide his or her future is the most important and fundamental right, saying, “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.” His claim is that most people agree that they are the best judges of their own self-interest and there is an innate value in the freedom to determine their own future. On these principles, Goldman starts by discussing conditions under which paternalism may be justified. Paternalism, Goldman says, is never to obstruct an individual’s deeper long-range preference. He starts off with a scenario in which an individual who wants to go to New York is about to accidentally get on board a train going to Boston. A good Samaritan, who we may assume is aware of the individual’s intentions of going to New York, pushes that individual off the train, displaying a form of paternalism. In Goldman’s terms, this scenario depicts justified paternalism because it only sacrificed the individual’s immediate autonomy in order to preserve his deeper long-range preference. In this situation the individual only acted the way he did (board the train to Boston) due to ignorance. His intentions were always the same as his long-term preference, of going to New York. But Controversy arises when an individual’s immediate preferences don’t match up with his or her long-term preferences. In one circumstance, the individ... ... middle of paper ... ... value ordering. Goldman says life does not hold value in itself; instead most individuals derive the meaning of life from their accomplishments and happiness to the point where individuals may even risk their health and lives to attain those. As established before about paternalism in a medical contest, it is only the patient’s true values that can be primary determinants of their futures. My beliefs lie with Goldman, in that I think people do place other core values ahead of health and pro-longed life. I believe that it is human nature for people to strive for happiness in life and I think people attain that happiness through achieving goals or doing something meaningful. I know people place health and long life in their core values but I do not believe that it is placed at the top of that list. As Goldman states, the patients go to a physician to seek out help
Alan Goldman argues that medical paternalism is unjustified except in very rare cases. He states that disregarding patient autonomy, forcing patients to undergo procedures, and withholding important information regarding diagnoses and medical procedures is morally wrong. Goldman argues that it is more important to allow patients to have the ability to make autonomous decisions with their health and what treatment options if any they want to pursue. He argues that medical professionals must respect patient autonomy regardless of the results that may or may not be beneficial to a patient’s health. I will both offer an objection and support Goldman’s argument. I will
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
In the realm of medical ethics, there are many topics that are debated and discussed, but there is not necessarily one clear, correct answer. One of these topics is paternalism. Many questions are bandied back and forth: is it beneficial, should it be disallowed entirely, are there instances when paternalism is good and beneficial, and the list goes on. For each of these questions there have been authors who have provided their comments. One such author is Alan Goldman. He draws a very firm line on paternalism, simply put: medical paternalism is deleterious to a patient because it intrudes on their primary rights of liberty and autonomy. This paper is going to expound upon Goldman’s viewpoint in detail, going through point by point how he presents his argument. There will then be a critique of Goldman’s viewpoint that will counter his main points. The counterpoints will show Goldman’s views on paternalism are incorrect and should not be considered valid.
Patient autonomy was the predominant concern during the time of publication of both Ezekiel and Linda Emanuel, and Edmund D. Pellegrino and David C. Thomasma's texts. During that time, the paternalistic model, in which a doctor uses their skills to understand the disease and choose a best course of action for the patient to take, had been replaced by the informative model, one which centered around patient autonomy. The latter model featured a relationship where the control over medical decisions was solely given to the patient and the doctor was reduced to a technical expert. Pellegrino and Thomasma and the Emanuel’s found that the shift from one extreme, the paternalistic model, to the other, the informative model, did not adequately move towards an ideal model. The problem with the informative model, according to the Emanuel’s, is that the autonomy described is simple, which means the model “presupposes that p...
Decision-making would be so much easier if we all maintained our autonomy in making the decision, however, because our decisions do not always abide by autonomistic values paternalistic intervention must occur. The purpose of autonomy is to allow us to choose to do things that affect only ourselves and does not negatively affect those around us. Unfortunately, many choices do, whether we know it or not, involve those in our environment. Paternalism is in place to protect the rights that are in our best interest and that will benefit us in the long run. Paternalistic intervention occurs when decisions are no longer in our best interests. If the decision is like to be regretted and irreversible in the future, paternalism is again justified. Autonomy is a fleeting concept, for as soon as someone chooses to do something that will later cause an addiction, his or her autonomy is lost. They no longer have the decision to do or not to do the action; it becomes a need.
Autonomy is an important ethical principal that should be considered with great attention, especially with the limitation of personal autonomy one finds in hospitals. Burkhardt (2008) and Nathaniel define autonomy as self-governing and describe it as including four elements, the ability to determine personal goals, decide on a plan of action, to be respected, and to have freedom to act on choices. In John’s situation, his vulnerability in contrast to the power that the health care professionals hold over him put all four of these elements into jeopardy. Since his advance directive and his current choices differ, the matter of respec...
Even since ancient times, it was recognized that doctors had power over their patients, and that there must be ethical implications coming with this responsibility. This was first represented in the Hippocratic Oath, which was created by an Ancient Gree...
In Rethinking Life and Death: The Collapse of Our Traditional Values, Peter Singer examines ethical dilemmas that confront us in the twentieth century by identifying inconsistencies between the theory and practice of ethics in medicine. With advancements in medical technology, we focus on the quality of patients’ lives. Singer believes that in this process, we have acknowledged a new set of values that conflicts with the doctrine of the sanctity of life.
The patient should have confident and trust in their doctor, but the doctor must also recognize that the patient is entitled to have an attitude to illness and his preferred way of tackling this (Turner-Warwick, 1994). Buchanan infers that paternalism eliminates an individual’s power of making their own choices and thus pressed into making decisions. To achieve public health goals, greater considerations must be directed toward promoting a mutual understanding of a just society (Buchanan, 2008). So, if people are given the choice to make certain decision over another, then they are still granted freedom of choice. Buchanan identifies 3 arguments in justifying paternalistic actions: informed consent, weak paternalism, and utilitarianism. To support his argument of informed consent, Buchanan admits there is no significant ethical concern because an individual may reach out to the professional for help, but it is problematic when an intervention is targeting the entire population (Buchanan, 2008). This point of view from Buchanan is flawed and completely limits what public health is all about. The Institute of Medicine (IOM) defines public health as “what we, as a society, do collectively to assure the conditions for people to be healthy.” With its use of the phrase “we, as a society,” the IOM emphasizes cooperative and mutually shared obligation and it also reinforces the notion that collective
In conclusion, every patient is worried about their rights to care but not so much are focused on the rights of the physicians providing the care. It is hard to establish a respectable practice if you are required to perform care for instances in which you object or do not want to be a part of. This detracts from the ethical background of practice and procedure every physician should hold to the highest standard.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Overall, it is vital to apprehend that when looking at the value of life, we are able to see in a view that surpasses all of the mess ups, failures, and setbacks. That looks passed all of the achievements, accomplishments, and profits. What truly defines the value of someone's life is looking at is the basic necessity of every human life, the
The principle of autonomy states, that an individual’s decision must be respected in all cases, also an individual can act freely in accordance to their plan. For example, in a case where a patient and family demands to continue medical or surgical care and a physician want the patient to stop further treatment. In this case the patient’s choice will matter the most. According to the principle of autonomy it will be the patients and family choice whether to continue or discontinue treatment. The principle of beneficence which states, “one must promote good” comes into play in this case. In accordance to beneficence the patient will not benefit from the physicians responses personally. He/she will not benefit from harming her body with more surgeries. The patient will be going against the principle non-maleficence, which states that “one must cause no harm to an individual” by causing harm to herself. In this case the physician is justified in his/her actions by discontinuing medical or surgical care to the patient because it will not it her. These principles are what healthcare provider use to help and guide patients with the ...
A child’s ability to make their own medical decisions has been based on many factors, of which include; a stable sense of self, established values and mature cognitive skills. For circumstances when the child want to have a say with their medical decisions, the authors discuss how the family-centered ethic model is used to be the most morally and legally correct in respect to child’s decisions (31).
“Is There Personal Responsibility In Healthcare?” Medical Malprocess. 4 March, 2009. Web.19 April, 2014. < http://thesystemmd.com/?p=230 >