A Compatible Defense of Respect for Autonomy and Medical Paternalism in the Context of Mental Capacity on the Grounds of Authenticity

Abstract

Respect for autonomy has become the guiding principle at the forefront of health-care decision-making. In an attempt to preserve this principle, patients can be neglected to make decisions for themselves during times when they cannot make fully capable decisions. Under certain circumstances, it is necessary to have others assist a patient in making decisions that may have a significant impact on the patient’s life and, will ultimately, respect the patient's prior expressed capable wishes and values. This thesis aims to provide arguments in favor of both respect for autonomy and medical paternalism under very specific circumstances. It provides traditional, contemporary and psychological arguments in support of respect for autonomy. Several key arguments in favor of medical paternalism are also presented on the grounds of the loss of personal identity, a social insurance policy and the abandonment of vulnerable patients. Furthermore, the difficulties involved in both accounts are also discussed with respect to the idealization of autonomy and the potential abuses involved in medical paternalism. This thesis concludes through drawing upon the notion of an authentic self as applied to this discussion, allowing for a compatible defense of these two traditionally competing theories.