Paternalism vs. Autonomy

Paternalismvs. Autonomy

LovebirdCase Study

Inthe medical field, paternalism refers to the power that medicalprofessionals are given to make a decision about a patient’shealth. The decision made should be for the benefit of the patient’swell-being. However, it has been debated that the patient ought tohave a choice on matters concerning their health. The issue ofautonomy has been debated for generations in the medical field.Autonomy refers to the right to make personal decisions withoutexternal influence (Brudney, 2009). In health care, the patient hasthe right to make sound choices in relation to their health.Therefore, medical professionals are expected to act ethically byrespecting the patient’s choice. Though this seems like the moraldecision, sometimes the patient may not be in a position to make asound decision (Alexia, 1514-1517). It is during such case that thosein health care could disagree with those authorized to care for thepatient.

Inthe case of Mr. Lovebird, the doctor is ethically conflicted when itcomes to deciding on the best course of action to take. It is asituation that tests the ethics and morals of the doctor. From adoctor’s professional perspective, the patient is only alivethrough machines. The doctor believes that taking a utilitarianismstep is the best way of handling the patient’s case(Escobar-Plagman, 2011). This means that the decision to unplug thepatient from the ventilator is for the good of most. In my view, thefamily has the right to making a decision in place of the patient whois unconscious. In any ethical decision making, the choices madeshould be non-maleficence. This means that the practitioner shouldensure that no harm befalls the patient.

Althoughthe family insists the patient should be kept alive by all means, thedoctor’s opinion is based on protecting the patient from more harm.I believe that the well-being of the patient should be consideredbefore making any decision (Andreoli, 2012). Where a patient cannotdecide personally, both family and health caregivers should cooperatewith each other to find a beneficial solution for the patient.


Brudney,D. (2009). Choosing for another: beyond autonomy and best interests.Hastings Center Report, 39(2), 31-37.

Escobar-Plagman,A. (2011). Moral Fatigue: Ethical reflections on the FHCDA [PDF filesize 71.3 KB] NYSBA Elder and Special Needs Law Journal, 21(4),11-14.

Andreoli,E. (2012, March 06). [Web log message]. Retrieved from

AlexiaTorke et al., Substituted Judgment: The Limitations of Autonomy inSurrogate Decision Making, Vol. 23 JGIM p. 1514-1517

BestInterest and Baby Moshe

Thecase of baby Moshe is one of the many that present conflict in healthcare. There are ethical and moral conflicts involved in this casewhere the patient is in no capacity to decide. Those responsible forthe baby’s care are expected to make choices that will be for thegood of the patient. It is also important that the doctor benefitsthe patient by improving their health. This then lays the moralburden on the physician and without judicial intervention, sometimesfocus on the patient’s interest is lost (McCormick, 2013).

Whereasthe patient’s health is a priority, decisions made for a patient intheir PVS state can be complicated. When Doctor Fuetile disagreedwith the family on taking tests, this possesses a greater risk to thepatient’s health. The time spent debating on the matter is likelyto delay the decision-making process, hence prolonging the patient’sagony. In such a case it is only right to put the interest of thepatient first (Drolet, 2012). In his capacity, the doctor has theauthority to apply his expertise (paternalism) and at the same timerespect the parent’s opinion.

Inconclusion, the ‘best interest’ of the patient means theimportance to care for them. Even though the baby is not in aposition to make a choice, those in authority have an obligation todo so. In my opinion, issues that conflict decision making such asreligious beliefs should not interfere with the effort to improve thepatient’s well-being. Bioethics principles and moral decisionsshould be put into consideration when finding a balance betweenautonomy and paternalism.


Drolet,MD, B. &amp White, MD, MA, C. (2012, July). Op-Ed: Selectivepaternalism [PDF file size 106 KB]. Virtual Mentor American MedicalAssociation Journal of Ethics, 14(7), 582-588. Retrieved from

Kon,A. A. (2010). The shared decision-making continuum. JAMA, 304(8),903-904.

McCormick,T. (2013, October 1). Principles of Bioethics: University ofWashington, 10-12.