Question

60 PCA O NO.32% 01:41 Hide Assignment Information Instructions CHAPTER 3-Paternalism and Patient Autonomy Read any two of the articles of student's choice, at the end of the assigned chapter in Vaughn's textbook, and submit a reading response. For each of the article one chooses to read, there are 3 questions posted below for students to respond. (So altogether, you'll be responding to 6 questions since you are reading 2 articles) Answer each question in your own words based on the careful reading of the assigned readings. Your response to each question must be at least one full paragraph. Answer each question in a new paragraph. The expected length of this assignment is 2-3 pages. I will not grade one paragraph papers. 1. "Paternalism," Gerald Dworkin a. What is Mill's view on liberty and paternalism? b. How does Dworkin justify limited forms of state paternalism? c. What does Dworkin say about the state's burden of proof in justifying paternalism? 2. "The Refutation of Medical Paternalism," Alan Goldman a. Why does Goldman say that decisions regarding people's own futures are best left up to them? b. According to Goldman, why is self- determination important? c. What does Goldman say about doctors' and patients' differing views on the importance of health and prolonged life? 3. "Why Doctors Should Intervene," Terrence F. Ackerman Monarding to Alarman how done the Submit Cancel

Answer 1

1a) Mill holds the view that individuals know their own interests best, and that others are invariably likely to misapply their good intentions toward that individual, so it is best to avoid paternalistic interference in general.

b)and c) Dworkin accepts the notion (famously articulated by John Stuart Mill) that society may sometimes justifiably restrict a person's liberty for purposes of self-protection or the prevention of harm to others. But he takes issue with Mill's related anti-paternalistic idea that a person "cannot rightfully be compelled to do or forbear because it will be better for him to do so." He argues that some limited forms of state paternalism can be justified, for "[u]nder certain conditions it is rational for an individual to agree that others should force him to act in ways which, at the time of action, the individual may not see as desirable." In a representative government, rational people could agree to restrict their liberty even when the interests of others are not affected. But in such cases the state bears a heavy burden of proof to show "the exact nature of the harmful effects (or beneficial consequences) to be avoided (or achieved) and the probability of their occurrence."

2. a) ,b) and c) The Refutation of Medical Paternalism," Alan Goldman

Except in a few extraordinary cases, strong paternalism in medicine is unjustified, Goldman argues. Patients have a right of self-determination, a right of freedom to make their own choices. Decisions regarding their own futures should be left up to them because persons are the best judges of their own interests and because self-determination is valuable for its own sake regardless of its generally positive effects. This right implies "the right to be told the truth about one's condition, and the right to accept or refuse or withdraw from treatment on the basis of adequate information regarding alternatives, risks and uncertainties." The faulty premise in the argument for medical paternalism, says Goldman, is that health and prolonged life can be assumed to be the top priorities for patients (and so physicians may decide for patients accordingly). But very few people always prioritize these values in this way.