AUTONOMY‘Therapeutic Privilege'In 1961, a study revealed that 88% ofdoctors routinely would not tell terminallyill cancer patients that they had cancer.Therapeutic Privilege: "When a doctor decidesfor a seemingly capable patient that it is in thepatient's best interests not to know certaininformation..." (Doing Right, 79)
‘Therapeutic Privilege’ In 1961, a study revealed that 88% of doctors routinely would not tell terminally ill cancer patients that they had cancer. • Therapeutic Privilege: “When a doctor decides for a seemingly capable patient that it is in the patient’s best interests not to know certain information.” (Doing Right, 79) AUTONOMY
AUTONOMYPaternalismTotreatsomeonepaternalisticallyistotreat the person in a way that ignores ordiscountshis/herwishesbutaimsatpromotingtheperson'sbestinterest.Question:What'swrongwithpaternalism?Do This!
Paternalism To treat someone paternalistically is to treat the person in a way that ignores or discounts his/her wishes but aims at promoting the person’s best interest. Question: What’s wrong with paternalism? AUTONOMY
AUTONOMYWhat is neglected in paternalism is that patientsas persons, have more to worry about thanmedicaltreatmentsWouldyoueverhideinformationfromapatient aboutaterminalorpreterminaldiagnosisinaneffortto bolster their spirit orattitude?Yes,Isoften itand give hopeevenifthere'slittlechance-14.6%Yes,unlesssomeoneisgoingtodieimminently,Idon'ttell themhowbaditis-1.7%No,ItellitexactlyasIseeit-59.8%Itdepends-23.8%
What is neglected in paternalism is that patients, as persons, have more to worry about than medical treatments AUTONOMY
CASEA 34 year-old man is brought to the emergencydepartment with fever, headache, and achange in mental status leading to significantdisorientation. His head CT is normal and heis in need of an urgent lumbar puncture andintravenous antibiotics. He is agitated and iswaving off anyone who tries to get near him.Co-workers accompany him. The residentinforms you that the patient is pushing awaythe lumbar puncture needle.What should you do?
CASE A 34 year-old man is brought to the emergency department with fever, headache, and a change in mental status leading to significant disorientation. His head CT is normal and he is in need of an urgent lumbar puncture and intravenous antibiotics. He is agitated and is waving off anyone who tries to get near him. Co-workers accompany him. The resident informs you that the patient is pushing away the lumbar puncture needle. What should you do?