Philosophy Compass 9 (3):194-203 (2014)

Daniel Groll
Carleton College
Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? In Medical Paternalism Part 1, I answered the first question. This paper answers the second. The place of paternalism in clinical medicine is best understood, I argue, in terms of the potential for conflict between the autonomy principle and the beneficence principle. The first enjoins clinicians to respect the decisions of patients with respect to their (the patients') own care. The second enjoins clinicians to act for the good of their patients. Clinicians act paternalistically, I argue, when they act on the beneficence principle to the exclusion of the autonomy principle. Understanding just what these principles amount to (particularly the autonomy principle) reveals that the autonomy principle defeasibly trumps the beneficence principle and that, as a result, acting paternalistically (at least when it comes to competent patients) is presumptively impermissible
Keywords Paternalism  Autonomy  Medical Ethics  Beneficence
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DOI 10.1111/phc3.12110
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References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
The Morality of Freedom.Joseph Raz - 1986 - Oxford University Press.

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Citations of this work BETA

A Normatively Neutral Definition of Paternalism.Emma C. Bullock - 2015 - Philosophical Quarterly 65 (258):1-21.

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