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University of Toronto Mississauga
Jonathan Peterson

Bioethics: SOC283 Lecture Two: Jan.13.2011 1 PRINCIPALS OF AUTONOMY The right to self-governance (the ability to make your own decisions) Case: Suppose you are a physician who specializes in treating mental illness. You have a patient named John. John has been in and out of mental institutions within the past couple of years, he has bi-polar disorders. He also suffers from some pretty serious delusions, he claims himself to be the best scientist, he claims he is a wrestler, he claims that he is in regular communication with the supernatural world; he also claims that he is very good at doing physics. John becomes your patient because he has a history of uttering death threats to peoplethis has gotten him in trouble with the law. He was put on trial and it was determined that he is not criminally responsible due to his mental illness. You look at his case, and you determine that over time his condition has been getting worse; unless a serious type of treatment is taken. Hence if this doesnt occur he cannot function external to the institution. You discover that there is a new medication which has not been used before; however you think it might help him regain his consciousness. You recommend the medication to John in order to help him overcome the mental illness. Johns response is NO. What should be done in this type of situation? This case brings upon a great emphasis on the physician-patient relationships. When thinking about the physician-patient relationships we need to consider 1. Goals of the physician-patient relationship 2.What are the dutiesobligation of the physician? 3. What is the role of the patients values? 4. How do they conceive autonomy? There are four models within the Physician-patient relationships: PATERNALISTIC MODEL Thinks of the relationship of the physician-patient, based on the same of a parent and child. Takes on the belief that because a parent knows best, the physician knows best The paternalistic model has goals which include: a. Promoting the patients well being and health b. Put the patients first (do what you think is best for the patient). This goal claims that there are objective values which are being promoted here. An example of an objective value could be HEALTH. Therefore, the objective value of health held within this model; suggests that anything should be done in order to maintain health.
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