Negative Critique on Alan Goldman's View on Medical Paternalism

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).

According to Higgs, one reason why a medical profession might withhold the truth from the patient is that : it may actually do harm through anxiety and distress that's produced after disclosing the truth. At times, truth-telling can lead to major/acute distress or long term disability. There can also be times where distress and fear can lead to a more severe condition of an illness or even causing a patient to deny the treatment. In either way, there is a high chance that the worsening of the illness may occur after a physician disclosing the truth to his/her

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.

1. Throughout history, a number of reformers have sought to improve the quality of medical care. What common thread connects them? Why did some fail? What were the successful able to see/do that others weren’t?

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.

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?

ii. Unconscious physician bias. Another theme in the reading that related back to class was the unconscious biases of doctors influence their interactions with patients, with consequences for patient outcomes. These unconscious biases affect interaction through the doctor’s communication. Establishing a basic understanding of treatment and diagnosis can foster better patient outcomes. An example of unconscious physician bias was Abraham 's focus on former secretary of the Department of Health and Human Services, Dr. Sullivan, in chapter eight. Dr. Sullivan’s campaign focused on the individual choice in adopting healthy lifestyle choices from diet to exercise. Skipping over racial disparities, the unconscious bias inferred through his words was that he considered the patient to blame whenever they fell ill.

This response is on an article written by Matthew K. Wynia of American Medical Association. The title of the paper is “Ethics and Public Health Emergencies: Restrictions on Liberty”, 2007. This paper was published in The American Journal of Bioethics, Volume 7(2), pages 1-5 in 2007.

MS. Washington is facing with ethical dilemmas which may affecst her decision and question her virtues if she were to choose between which funding to eliminate. If she chose between eliminating funds for adolescent well child screening or eliminating funds for a single costly program that provides catastrophic assistance she may be faced with challenging questions by staff, families, and patients. She is ambivalent in making the decision to cutting funds because she feels like she has a responsibility to provide autonomy, moral justice, and she also values the patient’s decision and feelings. Therefore, this makes it more difficult to make changes because she would probably face with many disagreement and questioned why chose one instead of

However, as time went on, several problems arose which had to do with the principle of justice in healthcare. In America, it is the accepted norm that it is unjust to treat one person better or worse than another person, in similar circumstances (Tong, 2007, p.29). In an attempt

Thanks for your question Dr. Haddad. Although it is neither an ethical theory nor an ethical principle, the elements of paternalism are being applied in this article (Haddad). More specifically, I believe that the idea of state paternalism is at work here. For example, the state of Nebraska is expected to begin to limit the amount of opioid prescriptions that prescribers can give to their patients. The potential guideline is intended to provide the most good for the citizens of Nebraska. Due to the abuse potential of these medications and the deadly side effects that can occur in an overdose, the state believes that overriding the autonomy of prescribers and patients will provide the most good overall. The ethical principles of beneficence

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

Futhermore, holding an individual as entirely responsible for their illness conflicts with health care’s obligation to treat the sick. Trust is an important factor between a patient and his/her physician. Physicians have a duty to act only in the interests of their patient and should not refuse to offer treatments or resources because of the patient’s responsibility for his/her illness. Additionally, patients must feel comfortable that the information that they share with their physician about their lifestyle will not negatively affect their care. If a patients fear that information about their lifestyle will reduce their chances of receiving scarce medical resources, not only may they withhold important information from the physician, but

Lying in medicine seems to be a requirement for doctors because they think that truthful information can hurt patients (Bok 222). According to doctors, while they are telling the truth, patients may have a heart attack or their psychological mechanism might be alleged. Furthermore, death comes more quickly. However, these are so rare and considering these universal is an overgeneralization. In addition, doctors consider their patient as a child and see them like a blind, suffering and passive toy (M.Smith and M.Weil 22); hence, doctors think that they can make choices for their patients without telling the truth to patients. However, this opinion just shows doctors’ paternalistic view (Bok 227).

In the third section, we will examine the role of the social sciences in deconstructing patient experiences of healthcare through concepts like the role of the doctor and the lay expert. We will apply this to different modes of doctor-patient communication and decision making, and explore the use of patient narratives in clinical care. This will be tied to the concept of social construction of illness through patient experiences. The final section will outline the role of medical ethics in influencing medical treatment, examining the way in which various ethical theories and principles serve to resolve issues related to the social determinants of health, and doctor-patient relationships, and the significance of concepts like confidentiality, consent, autonomy, and justice in discussing patient experiences.