Paternalism and the practitioner/patient relationship

Medical paternalism typically involves a medical practitioner interfering with a patient’s choices regarding her medical treatment for the sake of protecting or promoting that patient’s best interests. Although medical paternalism has been historically pervasive, concern over the importance of respecting patient autonomy in both ethics and law has led to a widespread rejection of medical paternalism in western medical ethics. In this chapter Emma C. Bullock provides an overview of the recent move away from medical paternalism before presenting two broad motivations for returning to a more paternalistic model in therapeutic practice: medical paternalism can be motivated out of an interest in protecting patient well-being or via considerations of the limits of patient autonomy. Despite these motivations Bullock outlines reasons to be cautious about readopting a paternalistic relationship between practitioner and patient.