Effectiveness of Goldman’s the Refutation of Medical Paternalism

1567 Words Nov 19th, 2011 7 Pages
Bioethics
Effectiveness of Goldman’s The Refutation of Medical Paternalism In his essay, The Refutation of Medical Paternalism, Alan Goldman states his argument against a strong doctor-patient role differentiation, in which the doctor may act against a patients’ immediate will in order to carry treatment in the patients’ best interest. Goldman frames his entire argument around the single assumption that a person’s freedom to decide his future is the most important and fundamental right as he claims “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.”[1] He claims that the majority of people would agree that they are the best judges of their own self-interest
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To argue the first premise, he appeals to common knowledge that doctors hold their occupations because they are more knowledgeable in a medical context on the options for improving health and longevity. With this in mind, he then establishes that individuals who consult physicians do so in order to prolong their life and improve their well-being. By establishing these foundational premises for paternalism in a medical context, Goldman can now argue that given a patient that is determined to be acting out of line with his true values and his actions might result in harm that is severe, certain, and irreversible, it is the physician’s professional to override the patients’ immediate rights in order to preserve that patients’ more long-term desires. But how can the physician determine whether the patient is acting in line with his true values in the case of withholding medical information from the patient? Goldman brings up a more controversial situation in which the physician effectively deceives the patient by withholding information pertaining to the patients’ medical condition from the patient himself. He maintains that the right to be told the truth is not innate, and just as in the case of coercion, it must be determined whether the information might be detrimental to the patients’ health directly or whether it might affect