The Right Kind of Paternalism
Marzuk, Peter M.
New England Journal of Medicine. 1985 Dec 5; 313(23): 1474-1476.
While welcoming the new emphasis on informed consent and the right of patients to refuse treatment, the author warns that at times patients' emotional responses to their illnesses may compromise their decision making abilities. He describes several situations where a patient's refusal of a diagnostic or therapeutic procedure might stem from denial, guilt, fear, misplaced anger, or depression, rather than from comprehension of the risks and benefits involved. Marzuk cautions his fellow physicians against discarding all remnants of paternalism in the face of legal pressures or fears of violating patient autonomy. The right kind of paternalism guards patients against the consequences of ill-conceived decisions based on emotion rather than understanding. (KIE abstract)
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