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The refutation of medical paternalism alan goldman
Ethical medical controversy
Ethical medical controversy
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Medical Paternalism
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.
The main reason paternalism is even debated revolves around one primary question: Is it beneficial to the patient? This one question has, and will continue to evoke strong responses from those who hold viewpoints across the spectrum. The spectrum varies from those who are in favor of paternalism, to those who think it should only be allowed if certain criteria are met, to those who strongly oppose it in any form at any time, but may consent to a few, rare occasions when it would be deemed acceptable. One such person who strongly opposes paternalism is Alan Goldman, and he presents his argument in an article entitled, “The Refutation of Medical Paternalism.”
Goldman’s main premise is straightforward: except for extraordinary cases, medical paternalism is neve...
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...ment, they are expecting, and ready to receive some sort of direction because they want a change or improvement in their health, and this indicates that, at that time, a patient is holding his health in high value.
Goldman presents the patient’s ranking value as fixed and decided with no ability to change. In actuality, a patient’s ranking of different values can change depending on the circumstances. It is clear that when a patient goes to visit the doctor, they are ranking their health over other concepts because, at that point in time, their health has become their primary concern and they want to preserve it so they can continue to enjoy their other liberties.
Sources
Vaughn, Lewis. Bioethics: Principles, Issues, and Cases. New York, NY: Oxford, 2013. Book.
Works Cited
Vaughn, Lewis. Bioethics: Principles, Issues, and Cases. New York, NY: Oxford, 2013. Book.
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
Bradley depicts a certain theory of which "life, liberty, and the pursuit of happiness really refer to the right to be protected from harm”(Bradley,2). He clearly argues that "because of the special things that it provides and protects, the right to healthcare is necessary for the enjoyment of what are commonly thought of as our basic liberty rights: life, liberty, and the pursuit of happiness” (Bradley,1). He states that for negative rights, action in a positive manner must be
Gedge, E., & Waluchow, W. (2012). Readings in health care ethics (2nd ed.). Toronto, Ontario: Broadview Press.
middle of paper ... ... Paternalism in Health Care (1982). Ethics. The. n.d. - n.d. - n.d.
9) Wall, L.L. (2006). The medical ethics of Dr J Marion Sims: a fresh look at the historical record. Journal of Medical Ethics, 32(6), 346-350. doi: 10.1136/jme.2005.012559
In the modern day, health care can be a sensitive subject. Politically, health care in America changes depending on whom is President. Obamacare and Trumpcare are different policies regarding health care, which many people have passionate feelings towards. However, not many Americans are informed about Norman Daniels’ view on health care. Throughout this paper I will be outlining Norman Daniels’ claims on the right to health care, and the fundamental principles in which he derives to construct his argument. By means of evaluating Daniels’ argument, I will then state my beliefs regarding the distributive justice of health care.
Denise Dudzinski, PhD, MTS, Helene Starks, PhD, MPH, Nicole White, MD, MA (2009) ETHICS IN MEDICINE. Retrieved from: http://depts.washington.edu/bioethx/topics/pad.html
Providers must act in the best interest of the patient and their basic obligation is to do no harm and work for the public’s wellbeing. A physician shall always keep in mind the obligation of preserving human life. Providers must communicate full, accurate and unbiased information so patients can make informed decisions about their health care. As a result of their recommendations, providers are responsible for generating costs in health care but do not generate the need for those expenses. Every hospital has both an ethical as well as a legal responsibility to provide care, even if the care may be uncompensated.
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
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
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.
Jecker, N. (1990). Integrating medical ethics with normative theory: Patient advocacy and social responsibility. 11(2), 125-139.
To conclude, health care is a primary responsibility of governments. They have to make sure that everybody has a total insurance which ensures equality between all members of the society with no segregation between rich and poor. Marxist theory mentioned that medicine became a profitable project more than a human task to serve people and save their lives as it was linked to capitalism. John, the poor factory man was guilty for doing such a sever action to keep hostages but at the same time he wasn’t guilty to be poor and didn’t have an insurance to save his son’s life. Physician role is to be fair when dealing with patients and to think of morals and ethics of the profession before thinking of money.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "’Rights- Based’ Approaches." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 23. Print.
McGee, Glenn and Arthur L. Caplan. "Medical Ethics." Microsoft® Encarta® 98 Encyclopedia. © 1993-1997: Microsoft Corporation. CD-ROM.