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Monday, June 23, 2014

Updated Definition of Paternalism

By Gerald Dworkin
Stanford Encyclopedia
Updated June 4, 2014

Here are two excerpts:

Paternalism is the interference of a state or an individual with another person, against their will, and defended or motivated by a claim that the person interfered with will be better off or protected from harm. The issue of paternalism arises with respect to restrictions by the law such as anti-drug legislation, the compulsory wearing of seatbelts, and in medical contexts by the withholding of relevant information concerning a patient's condition by physicians. At the theoretical level it raises questions of how persons should be treated when they are less than fully rational.

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Weak vs. strong paternalism

A weak paternalist believes that it is legitimate to interfere with the means that agents choose to achieve their ends, if those means are likely to defeat those ends. So if a person really prefers safety to convenience then it is legitimate to force them to wear seatbelts. A strong paternalist believes that people may have mistaken, confused or irrational ends and it is legitimate to interfere to prevent them from achieving those ends. If a person really prefers the wind rustling through their hair to increased safety it is legitimate to make them wear helmets while motorcycling because their ends are irrational or mistaken. Another way of putting this: we may interfere with mistakes about the facts but not mistakes about values. So if a person tries to jump out of a window believing he will float gently to the ground we may restrain him. If he jumps because he believes that it is important to be spontaneous we may not.

The entire definition is here.

Editor's note: Psychologists need to contemplate paternalism in many facets of care.  Not just with the example of suicide, there are host of other ways psychologist's may act paternalistically.  Think informed consent, goals in treatment, intrusive advocacy, respect for patient autonomy, and the collaborative nature of the therapeutic relationship, to name a few.
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