In “The Refutation of Medical Paternalism”, an excerpt from Alan Goldman’s The Moral Foundations of Professional Ethics, Goldman argues for faulty premises stated in medical paternalism. Specifically, he claims that it is intrinsically wrong to assume most human beings prioritize health and prolonged life in rational thought. In actuality, Goldman believes very few people classify health in this regard due to many other underlying motivations in one’s life that may be prioritized. Therefore, paternalistic interference would not be necessary and or matching the autonomy, values, and beliefs of the patient.
Goldman explains that if health and longevity are at the top of moral decisions, then social policy should follow the same. For example, our entire federal budget should be spent on health-related issues and defensive war, in which lives are risked and loss is rational, would not take precedence over biological existence and quantity of life. Furthermore, he states that personal lives often engage in “risky” activities just for pleasure and or convenience. It would not be irrational to trade quality for quantity when assessing one’s longevity. Lastly, Goldman brings up the point of people with bad states of consciousness, such as mental health detriments and depression. He argues that it may be better off to not prolong this suffering, so the instrumental worth of being alive is no longer a priority to those suffering from these mental illnesses.
The logic behind Goldman’s thoughts and evidence for his argument is clear and concise. However, I do not agree that very few people do not prioritize health and prolonged life when it revolves around patient and physician, or nurse, relationships and moral action in our society. From an ethical standpoint, one’s autonomy can not be completely fulfilled without being fully aware of their moral view. To achieve this, they must be in good health (or consciousness) and have grown to a certain extent of moral thinking. For example, the claim that parents can make decisions regarding their child’s health due to less knowledge regarding their moral judgments. Hence, longevity is necessary to have moral growth and a “corrected” autonomy. With this longevity, quality and quantity of life both increase, countering Goldman’s claim. Autonomy is, arguably, the most important principle in bioethical reasoning with an imperative connection to health and longevity. Therefore, many people prioritize their health status and longevity in moral judgments.
In respect of Goldman’s argument and evidence, I believe that the idea of social policy also prioritizing health and medical longevity is a strong assumption that every single person prioritizes their health. As a majority, most people prioritize their health when referring to morality. Yet, I do agree with Goldman that some people may have different priorities; but in different situations. For example, an elderly family member suffering to stay alive and preserving life may not be their choice. Combining my criticism and Goldman’s argument, most people prioritize their health and prolonged life for their moral decision-making, especially regarding a physician and a patient relationship, in most medical situations.