Izvorni znanstveni članak
Paternalism as a field of bioethical concern
Maja Žitinski
; University of Dubrovnik, Dubrovnik, Croatia
Sažetak
Paternalism becomes an issue in difficult situations when a physician in some way intentionally affects and limits the decision-making autonomy of the patient. Even though paternalism is literally interpreted as an attitude that appreciates paternal warmth, treating someone who is not a child paternalistically means treating him wrongly. It is reasonable for people to regard the respect of their rights as a protection against subjugation. If doing wrong to another person is contrary to what I would do to myself, then I must admit that nonreversible behaviour is wrong in itself. Whoever engages in nonreversible behaviour is doing wrong, or performing an irrational act. Autonomy and rights belong to the key metaethical concepts because vulnerability of all rational beings to subjugation is universal and our rational capacity to recognize it establishes its primacy over other moral ideals. Vulnerability to subjugation is an intrinsic
qualification of human existence because every human being can harm the other. My duty to be accountable for your vulnerability is implied in my power to harm you. In order not to harm each other I must move from the logic of power, to the logic of duty. What makes selfish action unethical is not that the agent has been a self centred paternalist only, yet the fact that selfish interests have served as criteria for action. This paper aims to infer what sorts of virtues are required to direct the physician to meet the interests of the patient as if they were his own, just for the sake of moral reason which requires not to harm the other person. The patient’s right to accept or refuse medical care changes the position of the physician’s power over the patient because moral principles are those of reciprocity. Bioethical quest for a correct method all moral agents ought to be guided by refers to the conviction that it is rational to come as close as possible to the ideal moral judgment. Since a system of moral rules free of
conflicts between principles and exceptions to principles does not exist, physicians are constantly confronted by conflicting demands in their need to decide what kind of consideration is weightier. Since paternalism is against the informed consent, it insists that patients believe in the doctor’s conscience and skill and act as the doctor tells them to do. If the physician acts beneficently to protect the patient from harm and the patient resists, the physician acts from the perspective of medicine which violates the autonomy model. Bioethics aims to advance human good because it provides a connection between goals of normative ethics and the establishment of principles for handling violations of rationally grounded moral decisions.
Ključne riječi
paternalism; power; right; beneficence model; autonomy model; moral reason; informed consent
Hrčak ID:
87432
URI
Datum izdavanja:
2.4.2012.
Posjeta: 2.451 *