Question

how do the problems of paternalism and autonomy play out in the case of euthanaisa?

Answer 1

Paternalism refers to courses of action (including decisions) that are done in the assumed interest of a person, but without or against that person's informed consent. However, if autonomy is seen as something that benefits patients, paternalism and autonomy need not be antithetical concepts.

Patient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, is currently undergoing this particular process.

Patient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.

Despite the fact that no single concept has been more relevant in contemporary bioethics than the concept of autonomy and that theautonomy argument has played a pivotal role as the principal argument for euthanasia,autonomy can be used in euthanasiaarguments in both support for and rejection ofeuthanasia.

Critics on autonomy argue that the change from paternalism to autonomy – posed a serious challenge to the historical authority of physicians and will likely have impact on the patients' care – for example dominance ofautonomy may reduce the influence of medical information or medical advice onpatient's decision

Paternalism is the interference with the liberty or autonomy of another person, with the intent of promoting good or preventing harm to that person. Examples of paternalism in everyday life are laws which require seat belts, wearing helmets while riding a motorcycle, and banning certain drugs.