Chapter 3 and Goldman

Question 1

autonomy

Answer 1

a person’s rational capacity for self-determination

Question 2

Autonomy Principle

Answer 2

Autonomous persons should be allowed to exercise their capacity for self-determination

Question 3

Paternalism

Answer 3

overriding of a person’s actions or decision-making for his/her own good

Question 4

weak paternalism

Answer 4

interference with persons who cannot act autonomously or whose autonomy is compromised

Question 5

strong paternalism

Answer 5

interference with persons who are (at least substantially) autonomous

Question 6

some justificatons of strong paternalism

Answer 6

what a person would consent to under ideal circumstances

Question 7

informed consent

Answer 7

is it always morally obligatory to provide the patient with diagnosis

Question 8

right to refuse treatment

Answer 8

p. 88 and p. 91

Question 9

futile treatment

Answer 9

the pointlessness/ineffectiveness of administering particular treatments
- do patients have the right to continue it? p. 85, p. 92

Question 10

physician autonomy p. 84

Answer 10

the freedom of doctors to determine the conditions they work in and the care they give

Question 11

2 ways to argue against paternalism

Answer 11

1. honoring the person’s autonomy will not in fact harm them (empirical question)
2. honoring the person’s autonomy even if it harms them in some ways is better than violating that autonomy because the harm of violating someone’s values/preferences (moral)

Question 12

Empirical Argument 1:
Doctors should not withhold information because they are bad judges of the impacts on patients
Goldman’s replies

Answer 12

this is weak. either get better at judging or withhold information to avoid risk of harm

Question 13

Empirical argument 2:
utilitarian could argue that lying might lead to worse overall consequences
- undermine trust in doctor
- lose patients
- undermine broader trust in doctors generally
Goldman’s reply:

Answer 13

just not true in many cases. you can always get away with lying

Question 14

Goldman’s preferred approach: refuting the moral argument for paternalism

Answer 14

1. disclosures of information sometimes increases depression and physical deterioration
2. disclosure may therefore be detrimental to health and hasten death
3. health and prolonged life have (absolute) priority
4. worsening health/life are assumed to be against the patient’s values
5. paternalism is justified

Question 15

Goldman’s challenge

this premise is not ture: health and prolonged life have (absolute) piority

Answer 15

ex. 1: there are rational orderings that do not prioritize it
ex. 2: takinglife/health threatening risks for personal values like completing an important project

Question 16

life/health as necessary means for other values?

Answer 16

if life/health are instrumentally valuable then it is the quality of life that matters, not life itself
- avoidance of depression and pleasure should not be overrated (pleasure machine example)

Question 17

what is among the highest values (usually not overridden by other values)

Answer 17

personal autonomy

Question 18

why does autonomy have value

Answer 18

because we desire it

Question 19

why do we value autonomy

Answer 19

without it we cannot rationally value anything else

Question 20

valuing autonomy is the central way we show…

Answer 20

we value the dignity of persons (respecting their rights)