Paternalism and Patient Autonomy
Paternalism is defined as decisions or actions that limit a person’s autonomy, for what is seen as in the best interest of that individual. Autonomy is the freedom of an individual to make their own decisions based on their rationales for self-determination. In the case medical ethics, paternalism and whether or not a doctor should honor a patient’s autonomy is a highly controversial topic. Two influential authors, Alan Goldman and Terrance Ackerman, have competing views on this subject.
Alan Goldman believes paternalism in medicine is not justified. In order to back up his reasoning, Goldman refuted the premises of medical paternalism, therefore making the argument for paternalism invalid. Goldman states…show more content… Ackerman states that there are many constraints on autonomous behavior. There are physiological constraints such as anxiety, fear and depression of the patient following knowledge of their condition. For example, a patient might be fearful that effects of a certain treatment might change them in appearance, making them unwilling to do it. It is also possible that a person does not even truly understand what the nature of their condition is, this is a cognitive constraint. There are also social constraints; people are expected to follow the norms of society, and maybe if a patients preference of treatment deviates from these norms they would be less likely to choose it, even though it is what they want. Another social constraint is the preference of the patients family members; for example, parents refusing treatment for their child out of belief in God. Ackerman argues that “ if serious constraints upon autonomous behavior are intrinsic to the state of being ill, then noninterference is not the best course, since the patients choices will be seriously limited” (Ackerman 101). The doctor must try to obtain enough psychiatric knowledge of their patient in order to cooperate with them. The main goal of this cooperation should be “to resolve the underlying physical defect, and to deal with cognitive, physiological, and social constraints in order to restore autonomous function” (Ackerman 102). In other words, the doctor’s main objective, before a treatment course is decided, should be to work with the patient on removing the constraints on autonomy. This allows the patient to make their own decision free from