Moral issue of paternalism and truth telling
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Moral issue of paternalism and truth telling

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Moral issue of paternalism and truth telling Moral issue of paternalism and truth telling Presentation Transcript

  • Moral Issue of Paternalism
  • Meng Tze/ Mencius
  • 4 beginnings that differentiate man from beast
    • Feeling of helpfulness and commiseration
    • Feeling of shame and dislike
    • Feeling of modesty and yielding
    • Sense of right and wron
  • 4 constant virtues
    • human-heartedness
    • Righteousness
    • Propriety
    • Wisdom
    • “ All men have a mind which cannot bear to see the suffering of others…”
  • Paternalism
    • From the Latin word
      • Paternos-father
    • Acting like a father to a person for the latter’s own good and interest
    • Intended to protect or advance the interest of its recipient, although such an act may go against the latter’s own immediate desires or may limit his freedom of choice.
  • TYPES OF PATERNALISM
    • (WELFARE)
      • PURE PATERNALISM
      • IMPURE PATERNALISM
    • (RECIPIENT’S DEFECT AND SAFETY)
      • RESTRICTED
      • EXTENDED
    • (PROMOTION OF GOOD AND PREVENTION OF HARM)
      • POSITIVE
      • NEGATIVE
    • (PATIENT’S SENSE OF VALUES)
      • SOFT
      • HARD
    • (RECIPIENT OF THE BENEFIT)
      • DIRECT
      • INDIRECT
  • PURE PATERNALISM
    • Justifies the intervention into a person’s life for the sole welfare of that person
    • Ex.
      • Advising pregnant women to do prenatal check-ups
  • IMPURE PATERNALISM
    • Justifies interference with another person not only for that person’s welfare but also for the welfare of another
    • Ex.
      • Parent of a JW should have a blood transfusion for the good of the patient and the family
  • RESTRICTED
    • Supports intervention which overrides an individual’s action because of some defect or weakness in that individual
    • Example
      • Telling the mother of the child with leukemia not to let his son play basketball
  • EXTENDED
    • Individual is restrained form doing something because it is too risky
    • Example
      • Not allowing the 5 year old boy to ride on the horse by himself.
  • POSITIVE PATERNALISM
    • Patient is forced into a rehabilitation program for his own good
    • Example
      • Drug addict forced into the mental asylum
  • NEGATIVE PATERNALISM
    • Prevention of harm
    • Example
      • Cigars and alcoholic beverages are taken away from an addict
  • Soft paternalism
    • Patient’s values are used to justify the intervention with his possible action or decision
    • Example
      • Comatose pt, is detaced form life-support machines because of her advance directives
  • Hard Paternalism
    • Patients’s values are not the ones used to justify a paternalistic act
    • Example
      • Doctor decided to go on CS of a CPD case.
  • DIRECT PATERNALISM
    • Benefit will be to the recipient
    • Example
      • Motorcyclist obliged to wear helmet
  • INDIRECT PATERNALISM
    • Benefits will be to the person, if other person is restrained from doing something.
  • Medical Context
    • Personal
      • individual
    • State paternalism
      • By the government
      • Legislature
      • Agency
        • All hospitals must hire only RN
  • JUSTIFICATIONS FOR PERSONAL PATERNALISM
    • The recipient of the paternalisic act is sick and consults the physician for medical advice
    • The patient has some incapacity which prevents him from making decisions
      • Nervous breakdown, minor, comatose
    • The probable benefit of paternal intervention outweighs the probable risk of harm form non-interference
    • Doctor has an obligation to act in the best interest of the patient
    • The patient upon consulting the physician, voluntarily transfers part of his autonomy to the doctor base.
  • Jusfication of state paternalism
    • Improve good the quality of medical education
    • Upgrade a high standard of medical care
    • To control drug addicted, drug abuses, spread of AIDS and sex related diseases
  • APPLICATION OF ETHICAL THEORIES
    • Natural law
      • Endorses paternalism
    • Kant’s ethics
      • Against paternalism
        • States that the person is a rational and autonomous being, self-regulating will
        • with exceptions, if the patient becomes unconscious then, the medical team should decide for the patient.
  • APPLICATION OF ETHICAL THEORIES
    • Rawl’s Ethics
    • Utilitarianism