Effectiveness of Goldman’s the Refutation of Medical Paternalism

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

Currently, most people generally accept a doctor’s word as truth and do not question him or her. When it comes to the medical field, patients can often feel overwhelmed by all the confusing medical terms being thrown at them, so they tend to sit back and do as the doctor says. Healthcare professionals sometimes take advantage of this fact and withhold important information from their patients. For instance, a study conducted by Lisa Lezzoni, MD, and her peers states that more than half of physicians lied to their patients about their diagnosis to put a more positive spin on it (Lezzoni, Rao, DesRoches, Vogeli, and Campbell). Healthcare professionals should disclose to the patient any information pertaining to the patient.

Within their paper, Childress and Siegler expand upon five models of physician-patient relationships that are omnipresent within the healthcare setting: Paternalism, Partnership, Friendship, Contract, and Technical Assistance (Childress and Siegler 74). By using these models, physicians often use these social frameworks to “appeal to ethical principles related to informed consent or shared decision-making or, at a deeper level, [the] goal of respecting patient autonomy” (Schwartz 2011). While the substantial purpose of using these models is to help alleviate the excruciating effects of disease, there are drawbacks to these models where efforts to respect patient autonomy may aggravate a patients’ suffering, specifically paternalism. Advocates

In discussing the difficult subject of biomedical ethics, there are different scenarios that play out differently because of people’s views about morality. Consider the scenario of an eighty year-old man whom we will call Mr. Simpson. Years of getting the flu with complications has left Mr. Simpson’s lungs very weak and unable to take another year of the flu. In fact another year of the flu will likely kill him. He does not want the flu shot because he sincerely believes that the actual flu shot will give him the flu. With further research, the doctor and the family find that Mr. Simpson will accept an immune boosting shot only. If the physician lies to Mr. Simpson about the injection then he will

The first commentary by Leonard Fleck defended the patient confidentiality by stating the physician is morally obligated to respect the patient’s confidentiality. The argument is well supported because Fleck implies that there is no

Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).

In the current situation, a physician is withholding a portion of information about the treatment that is used to treat the patient melanomas (10% of those whom survive can contract a form of leukemia) from his/her patient because the doctor is afraid that if he/she disclose the truth of the 10% to her patient, it may unduly alarm her. After, it may causes her to deny the treatment and thereby, spoiling the patient's chance for long term survival. However, in this situation, the patient is deciding a decision for his/her patient, without taking into considerations of the patient's right of autonomy and of self determination. Higgs also brought upon the "Principle of Ethics", which mentioned one part: that a physician at all time, deal honestly with his/her patients or colleagues. Therefore, i believe that Higgs would recommend the physician to tell his/her patient about the downside of the treatment and perhaps, let the patient decide whether or not he/she want to continue with the treatment or

Goldman’s critique of medical paternalism demonstrates the right for patient autonomy and decision to choose a treatment best suited to their needs and interests. Initially, physicians would not announce any form of cancer to their patients, as it was believed to result in physiological distress. Luckily, medical paternalism continues to be rejected in medical situations; the topics of outcomes research, scientific evidence, and court decisions help correct patient decisions on the best treatment.

Within healthcare, practitioners often have to make difficult decisions regarding the care of their patients. This could be to do with giving or withdrawing treatment, or as simple as sharing risk information (Glover, 1997). Ultimately, the practitioner must be able to rationalise any decision they have made (Morrison, 2009). With this in mind, the following assignment will draw upon an ethical dilemma and explore how theoretical perspectives can be utilised within the decision making process. Therefore it will also be pertinent to draw upon the law, and how this influences actions within health care. To facilitate this discussion, I will identify a scenario from practice that

A rights ethicist would argue the moral questions that it is the duty of physician's to "do no harm…and those rules are justified by reference to a general conception of personal and social welfare." The rights that are weighed desire to balance the risks to be taken against the possible good that could be attained through

The concept of autonomy in the medical practice brings many different views. Autonomy is the ability individuals have to be self-governing. In these different views there exist two schools of thought, one is the belief that people are born with the ability to do what they want their body and no organization can tell them what to do with their body, like the government. On the other hand, some people believe that it is more complicated and conditional on mental competency so that person can make rational decisions. However, the majority of people seem to advocate for autonomy. A particular largely uncontroversial discussion arises with the case of Dax Cowart, who had his right to autonomy taken from him in a tragic accident and is

Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.

Yeo (2010) point out that the possibility to retain some information from patients has been ordered for long in Australian law, as in other countries for the benefit of the patient. This has now been combined with the greater autonomy acknowledged to the patient in many jurisdictions. Although a clinical approach reveals that loyalty should guide the patient-physician relationship, there are still some situations in which information consent and truth telling may be controversial: in some circumstances, the physician should or may not tell the truth. The case at hand poses a dilemma regarding the right to know (Cherry & Jacob 2008).

Therefore, withholding a blood transfusion which might save a patient’s life, is likely to produce a net consequence of harm. Although some might argue that withholding treatment is not an action, but rather an omission, the omission itself still represents an intended choice undertaken by the doctor, and can therefore be treated as a course of action to a certain degree (Macklin 2003). Furthermore, the principles of nonmaleficence and beneficence have both been identified as a basis for paternalistic actions

“Professional integrity derives its substance from the fundamental goals or mission of the profession” (Wakin, 1996, para. 15). Meaning to say, individuals seek for a professional’s valued and ethical advice to which the professional holds their responsibility to maintain and exceeds the level of their expertise. For example, a general practitioner will treat a variety of patients, from all different walks of life with a plethora of different problems. It is their duty to diagnose and treat the patient to the best of their professional ability without prejudice. Another aspect of their duties is the principle of patient confidentiality. Medical professionals are legally bound to not divulge any information provided to them by their patients.