PHLB09H3 Lecture Notes - Lecture 1: Presupposition, Shared Decision-Making In Medicine, Applied Ethics
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Informed consent obligatory: deceit prohibited (no paternalism, refusing futile treatment permitted (for autonomous, elizabeth bouvia (p. 78, competent adult, quadriplegic, degenerative arthritis, seeks to end life, physicians refuse, patients sues hospital, wins, treating w/out informed consent= battery. If not, paternalism may be permissible: goldman: paternalism is impermissible, (cid:862)the (cid:373)ost i(cid:374)(cid:272)lusi(cid:448)e (cid:374)otio(cid:374) of ha(cid:396)(cid:373) is (cid:396)elati(cid:448)e to the (cid:448)alues a(cid:374)d p(cid:396)efe(cid:396)ences of the pa(cid:396)ti(cid:272)ula(cid:396) i(cid:374)di(cid:448)idual(cid:863) (cid:894)pg. Ill(cid:374)ess(cid:859) (cid:272)o(cid:374)st(cid:396)ai(cid:374)t o(cid:374) auto(cid:374)o(cid:373)(cid:455: physical, body becomes an obstacle, thwarting choice, loss of self-control. If (cid:272)o(cid:374)st(cid:396)ai(cid:374)t o(cid:374) auto(cid:374)o(cid:373)(cid:455)(cid:863) esse(cid:374)tial(cid:863) to ill(cid:374)ess, (cid:373)odif(cid:455) (cid:396)espe(cid:272)t fo(cid:396) auto(cid:374)o(cid:373)(cid:455): I(cid:374)flue(cid:374)(cid:272)e the fa(cid:373)il(cid:455)(cid:859)s (cid:271)elief: beyond legalism, legal notion of respecting autonomy, doctor and patient equals in an exchange, but doctors have advantage, expertise, (cid:862)(cid:449)he(cid:374) people a(cid:396)e si(cid:272)k, the fo(cid:272)us upo(cid:374) e(cid:395)ualit(cid:455) is te(cid:373)po(cid:396)a(cid:396)il(cid:455) (cid:373)ispla(cid:272)ed(cid:863) Interaction, not non-interference, frees patients from constraints on autonomy: paternalism serves autonomy- slogan. Aims: prevent deceit, protect confidentiality (informed decision)
