DRAFT FORMAL WRITING II Paternalism is the prevention of a persons right to choose what is best for themselves and an outside actor makes the decision based on what they believe is right. The importance of paternalism presents itself in many different areas. According to the book of bioethics, “The limits of our obligation to respect autonomous choices become important in the discussion of paternalism in medicine and social policy. ” (Bioethics p. 71)** The famous nineteenth century philosopher, John Stuart Mill addressed paternalism by saying, “He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because in the opinions of others, to do so would be wise, or even right. ” (John Stuart Mill, On Liberty, p. 223) He goes on to mention that one can be compelled to act in a certain way but not forced. In politics, leaders of authoritarian states often act paternally.
The rulers of such states make political, economic, and social decisions without the consent of the citizens that these decisions affect. A very common area in which paternalism occurs is in bioethics. Imagine this situation: The car begins to slip and loose traction. It swerves towards the cliff over the French Broad River. There was nothing to do to save him. The car goes off the edge and plunges into the freezing water below. As the emergency crew pulls out the car they find him dead.
The medical specialists analyze what happened and determine that he had struggled to get out but just couldn’t. When the wife shows up to the emergency room sobbing, yelling, “Where is my husband!! ” The doctor sits her down and tries to calm her but she is hysteric, she knows what he is going to say. “Mam your husband passed away. ” She asks what happened in between sobs and the doctor responds, “He lost control of his car but he died instantly with out any pain. ” She finally clams down and she is glad that he didn’t suffer.
She goes on living her life not knowing what really happened to her husband. In this situation, the doctor was acting paternally. He chose not to disclose the actual facts about what happened to her husband. He made the decision not to tell her because he believed it was in her best interest not to know the truth, considering the emotional state she was in. While the news about the husband’s death would have been traumatic for the wife to hear, it is debatable if it was the doctor’s right to make such a decision.
For this reason, paternalism in bioethics is a very controversial issue in the world of medicine. The Encyclopedia of Bioethics states, “The issue is not whether a physician actually knows what is best for the patient, but whether the patient has a right to refuse treatment even if the refusal is harmful and the treatment beneficial. ” (Encyclopedia of Bioethics p. 1987) Many believe it is acceptable for a medical professional to make decisions about what is in the best interest of a patient given their medical training and experience.
However others believe such personal decisions must be left in the hands of the people they directly affect, i. e. the patient or his family. Works Cited Encyclopedia of Bioethics. Ed. Stephen G. Post. Vol. 4. 3rd ed. New York: Macmillan Reference USA, 2004. p1983-1990. Mill, John Stuart. On Liberty. London: Longman, Roberts ;amp; Green, 1869; Bartleby. com, 1999. ** I have to go back to the library and find the book I photocopied this quote from** So I know that we have to have five sources, I am working on it but I haven’t found good enough quotes yet.