assignment # 8

What is paternalism? Why is the physician given the authority to practice paternalism? What are the situations wherein paternalism supercedes autonomy?

Paternalism refers usually to an attitude or a policy stemming from the hierarchic pattern of a family based on patriarchy, that is, there is a figurehead (the father, pater in Latin) that makes decisions on behalf of others (the "children") for their own good, even if this is contrary to their wishes. (ref: http://en.wikipedia.org/wiki/Paternalism)

The physician is given the authority to practice paternalism based on the fact that the physician really knows more about the human body and its illnesses (though not all) than the ordinary patient (as opposed to other doctors who might become your own patient). Hence, the physician can make decisions in terms of treatment modalities for the patient, though the patient can actually refuse any intervention if it violates his/her own beliefs and principles. Bottomline, the physician can make the decision for the patient for the patient's own good, especially if to save his/her life. This holds true for certain situations wherein paternalism supercedes autonomy like emergencies or minor patients whose parents or guardian are unavailable to decide, or even those who are mentally incapable of making their own decisions (ex. retarded, comatosed patients with no relatives, ignorant patients). In these cases, the physician is permitted to make decisions for them, like a father who knows better for the good of his children.