Effectiveness of Goldman’s the Refutation of Medical Paternalism
Bioethics
Effectiveness of Goldman’s The Refutation of Medical Paternalism In his essay, The Refutation of Medical Paternalism, Alan Goldman states his argument against a strong doctor-patient role differentiation, in which the doctor may act against a patients’ immediate will in order to carry treatment in the patients’ best interest. Goldman frames his entire argument around the single assumption that a person’s freedom to decide his future is the most important and fundamental right as he claims “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.”[1] He claims that the majority of people would agree that they are the best judges of their own self-interest and that there is innate value in the freedom to determine one’s own future. On this foundation, he begins by describing the criteria under which paternalism might be justified. Paternalism, Goldman argues, is never to impede upon an individuals’ deeper long-range preference. He starts with a simple scenario in which an individual, who wishes to go New York is about to accidentally board a train going to Boston. A good Samaritan, who is assumed to be aware of this individuals’ intentions of going to New York, forcibly pushes that individual off the train, exercising a form of paternalism. According to Goldman, this scenario illustrates justified paternalism as it only sacrificed this individuals’ immediate autonomy in order to preserve the his deeper long-range preference. In this scenario, the individual only acted the way he did due to complete ignorance; his immediate intentions were always in line with his long-term preferences. Controversy arises, however, when an individuals’ immediate preferences are not consistent with his long-range preferences. In certain circumstances, an individual might not act according to his own values due to ignorance, failure to consider the likelihood of certain consequences, or
Effectiveness of Goldman’s The Refutation of Medical Paternalism In his essay, The Refutation of Medical Paternalism, Alan Goldman states his argument against a strong doctor-patient role differentiation, in which the doctor may act against a patients’ immediate will in order to carry treatment in the patients’ best interest. Goldman frames his entire argument around the single assumption that a person’s freedom to decide his future is the most important and fundamental right as he claims “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.”[1] He claims that the majority of people would agree that they are the best judges of their own self-interest and that there is innate value in the freedom to determine one’s own future. On this foundation, he begins by describing the criteria under which paternalism might be justified. Paternalism, Goldman argues, is never to impede upon an individuals’ deeper long-range preference. He starts with a simple scenario in which an individual, who wishes to go New York is about to accidentally board a train going to Boston. A good Samaritan, who is assumed to be aware of this individuals’ intentions of going to New York, forcibly pushes that individual off the train, exercising a form of paternalism. According to Goldman, this scenario illustrates justified paternalism as it only sacrificed this individuals’ immediate autonomy in order to preserve the his deeper long-range preference. In this scenario, the individual only acted the way he did due to complete ignorance; his immediate intentions were always in line with his long-term preferences. Controversy arises, however, when an individuals’ immediate preferences are not consistent with his long-range preferences. In certain circumstances, an individual might not act according to his own values due to ignorance, failure to consider the likelihood of certain consequences, or