Abstract
Two dogmas of liberalism in the therapeutic setting are challenged: (1) that patients have a ready-made ability to act autonomously; and (2) that non-intervention by physicians is the best strategy for protecting the autonomy of patients. Recognition of the impact of illness upon autonomous behavior forms the basis of this challenge. It is suggested that autonomy is better conceived as a process of personal growth by which patients become better able to overcome the disruptive effects of illness. The physician is assigned an active role in the achievement of this therapeutic goal. The implications of this new liberal theory are illustrated by reference to the informed consent issue.
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References
Annas, G.: 1982, ‘The emerging stowaway: Patients' rights in the 1980s’, Law, Medicine and Health Care, February 1982, 32–35, 46.
Arrow, K.: 1974, ‘Government decision making and the preciousness of life’, in L. Trancedi (ed.), Ethics of Health Care, National Academy of Science, Washington.
Beauchamp, T. and Childress, J.: 1980, Principles of Biomedical Ethics, Oxford University Press, New York.
Brody, H.: 1981, ‘Hope’, Journal of the American Medical Association 246, 1411–1412.
Cassell, E.: 1976, The Healer's Art, Lippincott, New York.
Cassell, E.: 1978, ‘What is the function of medicine?’, in E. McMullin (ed.), Death and Decision, Westview Press, Boulder, Colorado, pp. 35–44.
Cassileth, B. et al.: 1980, ‘Informed consent — Why are its goals imperfectly realized?’, The New England Journal of Medicine 302, 896–900.
Cousins, N.: 1980, ‘A layman looks at truthtelling’, Journal of the American Medical Association 244, 1929–1930.
Engelhardt, Jr., H.T.: 1978, ‘Rights and responsibilities of patients and physicians’, in M. Bayles and D. High (eds.), Medical Treatment of the Dying: Moral Issues, Schenkman, Cambridge, Massachusetts, pp. 9–29.
Grundner, T.: 1980, ‘On the readibility of surgical consent forms’, The New England Journal of Medicine 302, 900–902.
Hobbes, T.: 1909, Leviathan, Oxford University Press, New York.
Jackson, D. and Youngner, S.: 1979, ‘Patient autonomy and “death with dignity”’, The New England Journal of Medicine 301, 404–408.
Kaplan, D.: 1981, ‘Interventions for acute stress’, in J. Spinetta and P. Spinetta (eds.), Living With Childhood Cancer, Mosby, St. Louis, pp. 41–49.
Ketchum, S. and Pierce, C.: 1981, ‘Rights and responsibilities’, Journal of Medicine and Philosophy 6, 271–279.
Ladd, J.: 1982, ‘The distinction between rights and responsibilities: A defense’, Linacre Quarterly 49, 121–142.
Locke, J.: 1946, The Second Treatise on Government, Basil Blackwell, Oxford, England.
Meisel, A. and Roth, L.: 1981, ‘What we do and do not know about informed consent’, Journal of the American Medical Association 246, 2473–2477.
Morrow, G.: 1980, ‘How readable are subject consent forms’, Journal of the American Medical Association 244, 56–58.
Muss, H. et al.: 1979, ‘Written informed consent in patients with breast cancer’, Cancer 43, 1549–1556.
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research: 1978, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research, U.S. Government Printing Office, Washington.
Priluck, I. et al.: 1979, ‘What patients recall of the preoperative discussion after retinal detachment surgery’, American Journal of Ophthalmology 87, 620–623.
Robinson, G. and Merav, A.: 1976, ‘Informed consent: Recall by patients tested post-operatively’, The Annals of Thoracic Surgery 22, 209–212.
Van Eys, J.: 1978, ‘What do we mean by “the truly cured child”?’ in J. Van Eys (ed.), The Truly Cured Child: The New Challenge in Pediatric Cancer Care, University Park Press, Baltimore, pp. 81–98.
Veatch, R.: 1976, Death, Dying and the Biological Revolution, Yale University Press, New Haven.
Veatch, R.: 1981, A Theory of Medical Ethics, Basic Books, New York.
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Ackerman, T.F. Medical ethics and the two dogmas of liberalism. Theor Med Bioeth 5, 69–81 (1984). https://doi.org/10.1007/BF00489247
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DOI: https://doi.org/10.1007/BF00489247