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Autonomy and paternalism in medicine

B J Pollard

    The Medical Journal of Australia
    |December 6, 1993
    PubMed
    Summary

    This study re-examines medical ethics concepts like autonomy and paternalism. It highlights how illness impacts decision-making capacity, challenging current interpretations of these ethical principles in clinical practice.

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    Area of Science:

    • Medical Ethics
    • Clinical Decision-Making

    Background:

    • Current medical ethics face scrutiny, necessitating re-examination of core concepts.
    • Autonomy and paternalism lack universally accepted meanings, impacting ethical and clinical discourse.
    • The concept of autonomy has shifted from its moral origins to often signify mere expressed intention.

    Purpose of the Study:

    • To re-examine the applied contexts of ethical concepts, specifically autonomy and paternalism.
    • To address the ambiguity in the definitions of autonomy and paternalism within medical practice.
    • To highlight the impact of illness on patient decision-making capacity.

    Main Methods:

    • Conceptual analysis of autonomy and paternalism in medical ethics.
    • Review of ethical and clinical discussions on patient autonomy and medical paternalism.
    • Examination of how illness transforms decision-making capacity.

    Main Results:

    • Autonomy is frequently reduced to expressed intention, diverging from its moral roots.
    • Paternalism is often viewed as the opposite of autonomy and largely excluded from medicine.
    • The significant influence of illness on a patient's capacity to make decisions is commonly overlooked.

    Conclusions:

    • Re-evaluation of autonomy and paternalism is crucial in light of their evolving meanings and clinical application.
    • The impact of illness on decision-making capacity requires greater consideration in ethical frameworks.
    • A nuanced understanding of autonomy and paternalism is needed for ethical medical practice.
    Keywords:
    Professional Patient Relationship

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