Ethical Theory and Moral Practice

, Volume 19, Issue 2, pp 409–424 | Cite as

Mandatory Disclosure and Medical Paternalism

  • Emma C. Bullock


Medical practitioners are duty-bound to tell their patients the truth about their medical conditions, along with the risks and benefits of proposed treatments. Some patients, however, would rather not receive medical information. A recent response to this tension has been to argue that that the disclosure of medical information is not optional. As such, patients do not have permission to refuse medical information. In this paper I argue that, depending on the context, the disclosure of medical information can undermine the patient’s ability to exercise her autonomy or have therapeutically detrimental effects. In the light of these insights I go on to develop a context-sensitive approach to medical disclosure. The advantage of this account is that it addresses concerns on both sides of the debate; whilst it acknowledges that patients do not have an exercisable ‘right not to know,’ it allows that in some cases medical information ought to be withheld.


Patient autonomy Paternalism Epistemic paternalism Informed consent The right not to know 



I would like to thank my colleagues at Central European University for their comments on an earlier draft of this paper. Substantial revisions of the paper were carried out at the Ethox Centre, Oxford as part of the Caroline Miles visiting scholarship; many thanks, especially to Michael Parker, Michael Dunn and Mark Sheehan. I am also grateful to members of the Institut für Experimentelle Medizin department, Christian-Albrechts-Universität zu Kiel for their insightful comments, and to two anonymous reviewers for their encouragement and direction.


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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  1. 1.Central European UniversityBudapestHungary

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