Moral Issue of Paternalism

Moral Issue of
Paternalism
Louradel U. Alfonso, MAN, RN
Meng Tze/ Mencius
4 beginnings that
differentiate man from
1. Feeling of helpfulness
beast
and commiseration
2. Feeling of shame and
dislike
3. Feeling of modesty
and yielding
4. Sense of right and
wrong
4 constant virtues
1. humanheartedness
2. Righteousness
3. Propriety
4. Wisdom
All men have a mind which
cannot bear to see the
suffering of others
Paternalism
From the Latin word
Paternos-father
Acting like a father to a person for

the latters own good and interest
Intended to protect or advance the
interest of its recipient, although
such an act may go against the
latters own immediate desires or
may limit his freedom of choice.
TYPES OF PATERNALISM
1.
1.
2.
2.
1.
2.
3.
1.
2.
4.
(WELFARE)
PURE PATERNALISM
IMPURE PATERNALISM
(RECIPIENTS DEFECT AND SAFETY)
RESTRICTED
EXTENDED
(PROMOTION OF GOOD AND PREVENTION OF HARM)
POSITIVE
NEGATIVE
(PATIENTS SENSE OF VALUES)

1.
2.
5.
SOFT
HARD
(RECIPIENT OF THE BENEFIT)

1.
2.
DIRECT
INDIRECT
PURE PATERNALISM
Justifies the intervention into a
persons life for the sole welfare
of that person
Ex.
Advising pregnant women to do
prenatal check-ups
IMPURE PATERNALISM
Justifies interference with
another person not only for that
persons welfare but also for the
welfare of another
Ex.
Parent of a JW should have a blood
transfusion for the good of the
patient and the family
RESTRICTED
Supports intervention which
overrides an individuals action
because of some defect or
weakness in that individual
Example
Telling the mother of the child with
leukemia not to let his son play
basketball
EXTENDED
Individual is restrained from
doing something because it is
too risky
Example
Not allowing the 5 year old boy to
ride on the horse by himself.
POSITIVE PATERNALISM
Patient is forced into a
rehabilitation program for his
own good
Example
Drug addict forced into the mental
asylum
NEGATIVE PATERNALISM
Prevention of harm
Example
Cigars and alcoholic beverages are
taken away from an addict
Soft paternalism
Patients values are used to
justify the intervention with his
possible action or decision
Example
Comatose pt, is detached from lifesupport machines because of her
advance directives
Hard Paternalism
Patientss values are not the
ones used to justify a
paternalistic act
Example
Doctor decided to go on CS of a
CPD case.
DIRECT PATERNALISM
Benefit will be to the recipient
Example
Motorcyclist obliged to wear helmet
INDIRECT PATERNALISM
Restricts the activity of some individuals
in order to prevent harm or to promote
the good of others who cooperate with
or participate in a harmful act.
Ex. Banning the production of marijuana
Restricts the liberty of one group to protect
the others
Medical Context
Personal
Treatment of individuals in a fatherly way for
their pown good.
State paternalism
imposing state laws upon the person most
affected by the decisions to be made, without
adequately heeding that persons own values
or power to make decisions that directly affect
them. These laws are made for the benefit and
protection of the people.
JUSTIFICATIONS FOR
PERSONAL
PATERNALISM
The recipient of the paternalisic act is sick and
consults the physician for medical advice
The patient has some incapacity which prevents him
from making decisions
Nervous breakdown, minor, comatose
The probable benefit of paternal intervention

outweighs the probable risk of harm from noninterference
Doctor has an obligation to act in the best interest of
the patient
The patient upon consulting the physician, voluntarily
transfers part of his autonomy to the doctor.
Jusfication of state
paternalism
Improve the quality of medical

education
Upgrade a high standard of
medical care
To control drug addicts, drug
abuses, spread of AIDS and sex
related diseases
APPLICATION OF ETHICAL
THEORIES
Natural law
Endorses paternalism
Kants ethics
Against paternalism
States that the person is a rational and
autonomous being, self-regulating will
with exceptions, if the patient becomes
unconscious then, the medical team
should decide for the patient.
END

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Moral Issue of Paternalism

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Moral Issue of

Meng Tze/ Mencius

Acting like a father to a person for

(PATIENTS SENSE OF VALUES)

(RECIPIENT OF THE BENEFIT)

The probable benefit of paternal intervention

Improve the quality of medical

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