- Personal Paternalism
- Have any of you played injured, or had a teammate who has played injured?
- Whose decision ultimately should it be if an athlete plays or not?
- Under what conditions should this responsibility shift?
- Should the athlete have complete control to make his or her own decisions?
Why or why not?
- What are the potential problems with allowing the athlete complete
- Is it right for governing agencies to impose restrictions on autonomy?
Seatbelts? Protective Equipment?
- Two sides of paternalism (Beneficent vs. coercive)
- Weak paternalism (acting for others when they are not capable of acting for
- Childress (1980) “justification exists for paternalistic intervention when the
probability of harm and defects in the decision maker are evident and are
coupled with evidence that the harm to be prevented outweighs the loss of
o Who’s to say what is more important?
o 2 Scenarios presented to US Olympians or aspiring Olympians: “You
are offered a banned performance enhancing substance with 2
guarantees- you will not be caught, and you will win. Would you take
this substance? 195/198 said yes” “same as the last scenario except
you will win every competition in the next 5 years, but you will then
die from the side effects of this substance? More than half said yes”
o Maybe people aren’t incapable of making decisions, just are so
coerced by the lucrative prize
- What about paternalism in children?
- Should the coach or team physician ever have the right to explicitly make the
decision? When would this be warranted?
Shared Decision Making