lesson 13: PATERNALISM AND TRUTH-TELLING

Question 1

The deliberate overriding of a patient’s opportunity to
exercise autonomy because of a perceived obligation of
beneficence is called

Answer 1

paternalism

Question 2

“Interventions intended to prevent or mitigate harm to or to benefit a person, despite the fact that the person’s risky choices and actions are informed, voluntary, and autonomous”

It is classified as what type of paternalism

Answer 2

Hard Paternalism

Question 3

to protect persons from their own non-voluntary conduct. People justify its acceptance when a person may be unable to make reasonable, autonomous decisions.

is classified as what type of paternalism?

Answer 3

Soft Paternalism

Question 4

an individual decides on the basis of one’s best knowledge of what is good for another person

Answer 4

Personal Paternalism

Question 5

decisions regardless of non-consenting patient

Answer 5

Personal Paternalism

Question 6

control of an agency, or other governmental bodies over particular kinds of practices and procedures in Medicine

Answer 6

State Paternalism

Question 7

examples of State Paternalism

Answer 7

LAWS AND REGULATION
 Medical Practice
 Restrictions Research
 Licensing
 Drugs

Question 8

Issues in Medical Paternalism

Answer 8

-Lack of respect for patient’s autonomy
- Failure to inform the patient of true diagnosis
- Failure to disclose other available and acceptable treatment
options

Question 9

the act or an instance of justifying something

Answer 9

Justification

Question 10

an acceptable reason for doing something

Answer 10

Justification

Question 11

something that justifies an act or way of behaving

Answer 11

Justification

Question 12

Justification for Personal Paternalism

Answer 12

 The recipient of the paternalistic act is sick and consults
the physician for medical advice
 The patient has some incapacity (nervous breakdown, minor or comatose) which prevents him from making decisions
 The probable benefit of paternal intervention outweighs the probable risk of harm form non interference
 Doctor has an obligation to act in the best interest of the patient
 The patient upon consulting the physician, voluntarily transfers part of his autonomy to the doctor

Question 13

Justification for State Paternalism

Answer 13

Used to describe any situation in which the state intervenes in citizen activity within its jurisdiction to promote, modify, hinder or abolish that activity with the justification that such intervention is for the benefit of the individuals or groups or even the whole society

Question 14

Approaches of truth telling:
ends importance to the patient as a person

Answer 14

person-centered

Question 15

Approaches of truth telling:
stresses the nature of the problem, or the severity of the patient’s illness

Answer 15

problem-oriented

Question 16

Delineates our relationship with other persons, like
ourselves, other subjects.

Answer 16

I-IT

Question 17

Delineates our relationship with other persons, like
ourselves, other subjects.

Answer 17

I-THOU

Question 18

is one of the core duties of medical practice. It
requires health care providers to keep a patient’s personal health
information private unless consent to release the information is
provided by the patient

Answer 18

Confidentiality

Question 19

Protecting Confidential Information

Answer 19

Ensuring that you only disclose confidential information to
those who need to know.

Question 20

You may break confidentiality when:

Answer 20

 The information disclosed to you suggests that something
may happen or have happened that is not in the
organisation’s interests.
 If something has happened this is against your professional
code of conduct, or which you believe to be wrong.
 There is a possibility that a criminal offence has been
committed.
 If there is suspected child abuse or abuse of another
vulnerable person

Question 21

Importance of Ethical Theories

Answer 21

 Understanding ethical theory helps inform ethical decisionmaking.
 Improves confidence and competence for making future ethical
decisions
 Helps to understand how and why patients or colleagues may
not share the same moral outlook.

Question 22

How do ethical theories relate to decision-making?

Answer 22

It represents the viewpoints from which individuals seek
guidance as they make decisions.

Question 23

Why do we need to make ethical decisions and actions?

Answer 23

Ethical decisions generate and sustain trust; demonstrate
respect, responsibility, fairness and caring; and are
consistent with good citizenship. These behaviors provide
a foundation for making better decisions by setting the
ground rules for our behavior

Question 24

Justifications of Truth-Telling

Answer 24

 Our human and moral quality as persons is taken away
from us if we are denied whatever knowledge is available
about our condition as patient
 As patients, we have entrusted to the physician any
knowledge he has about ourselves, so the facts are ours
and not his
 The highest conception of the physician-patient
relationship is a personalistic one which is based on
mutual confidence and respect for each other’s rights
 To deny a patient pertinent knowledge about himself,
especially in a life-and-death situation, is to deprive him
the ample time to prepare for his own death or to carry
out responsibilities that are based solely on his decisions
or actions

Question 25

Challenges of Truth-telling

Answer 25

 Patients being autonomous individuals
 Conflict with other obligations
 Increases of respect between physician and patient
 Health professionals must be cautious of giving truthful
information