Webster’s dictionary is defines Paternalism as the policy or practice on the part of people in positions of authority of restricting the freedom and responsibilities of those subordinate to them in the subordinates’ supposed best interest. As we can assume such characterization leaves a negative association with such acts, as it eliminates individuals right to self-sufficiency also known as autonomy. As discussed there are a variety of types of paternalism. The author’s highlight one, which seems to have the individual’s best interest in mind, libertarian paternalism. The basic idea is that private and public institutions might nudge people in directions that will make their lives go better, without eliminating freedom of choice. The paternalism consists in the nudge, which can wrongly be considered coercion but it is not; and the libertarianism consists in the perseverance on freedom, and on imposing little or no cost on those who seek to go their own way, which is based in autonomy.

One core example of libertarian paternalism provided by Thaler’s and Sunstein, is one by which workers can sign up to devote some of their future wage increases to savings. Another example is the automatic enrollment plan, in which workers are automatically enrolled in a savings plan, but can opt out with no trouble and at no expense if they choose to do so (Thaler, 385). One of the essential arguments is that because default rules and starting points often matter, institutions can’t avoid pushing people, which is the “paternalism” factor. If 0% of take-home pay goes to savings, it isn’t because nature so intended it.

The authors go on to argue that people are not always making choices in their best interest. Thaler and Sunstein show us that making decisions, which provide the best benefits to an individual, is not always the outcome. For example Sunstein and Thaler might agree that anyone who does not see the benefits of saving for retirement is not thinking rationally, and would not be making the best decision for their benefit. If a libertarian paternal decision had been made for the individual in their choices, we can guarantee that it had a positive impact even if it is that not morally acceptable. Libertarian paternalism is similar to asymmetric paternalism, which refers to policies designed to help people who behave irrationally and so are not advancing their own interests, while interfering only minimally with people who behave rationally (Colin Camerer, 1220). Such policies are also asymmetric in the sense that they should be acceptable both to those who believe that people behave rationally and to those who believe that people often behave irrationally.

What libertarian paternalists add is that the opposition between “individual choice” and “institution” is confusing and unhelpful when institution is unavoidably establishing unseen rules that govern outcomes if choices haven’t been specifically made, and that influence people’s choices in any situation. Its is important to note that both private and public institutions can’t possibly avoid a form of paternalism, so long as they establish rules and starting points. The question is how to make those starting points as good as possible, while also preserving free choice. So, restraints on ourselves may not be so much external restraints by others who do not like the way one lives and chooses, but restraints that I choose for myself in a moment of deliberate rationality, aware that another I, far from the best self, may make bad choices if I am not restrained by the laws.

Works Cited

Colin Camerer, Samuel Issacharoff, George Loewenstein, Ted O’Donoghue & Matthew Rabin. 2003. “Regulation for Conservatives: Behavioral Economics and the Case for “Asymmetric Paternalism”. 151 University of Pennsylvania Law Review 101: 1211–1254.Web.

Thaler, Richard H., and Cass R. Sunstein. “BEHAVIORAL ECONOMICS, PUBLIC POLICY, AND PATERNALISM: LIBERTARIAN PATERNALISM.” Arguing about Bioethics. New York: Routeledge, 2012. 386-391. Web.

Background

In this case you have a 40-year-old women named Sue Rodriguez how was diagnosed with amyotrophic lateral sclerosis in 1991 and in 1993 she was given estimation that she had roughly two-fourteen months to live. As her prognosis was that she would soon lose the ability to swallow, speak, walk and move with out assistance. In addition she would eventually lose her ability to breathe on her own with out the help of a respirator. As her illness progressed Sues abilities began to deteriorate, and she began wishing to maintain control over how and why she would die.   Ultimately, Sue petitions to allow a medical practitioner set up technological means which she might, by her own hand, at the time of her choosing, end her life.

Dilemma

This case raises multiple concerns. One would be addressing the if assisted suicide should be legal or not. That it is not legal discriminates against those who are dying but physically unable to commit suicide without assistance. As Sue’s illness has began compromising her quality of life her desire to end her life and maintain control over her body a doctor’s obligation to nonmaleficence. The bigger picture is the issue of whether a patient’s autonomy is more important than or maleficence.

Analysis

I find it for religious reasons not acceptable for the doctor to support Sue’s wishes to end her own life. From a moral stand point I don’t believe it is the doctors responsibility to make the decision to aiding to helping an individual end their life. While the case discusses that assisted suicide is unwarranted because of accessibility to proper pain administration this presents a conflict with as if the doctor administers drugs that will result in death instead of pain med, the doctor is essentially causing more harm than healing. As discussed in Beauchamp and Childress, “Killing is unjustified when it deprives the person who dies of opportunities and goods. However, if a person freely authorizes death, making an autonomous judgment that cessation of pain and suffering through death constitutes a personal benefit rather than a setback to interests, then active aid-in-dying at the person’s request involves neither harming nor wronging” (Beauchamp and Childress 182). Which seems to justify Sue’s request, as Sue is competent and is making the autonomous decision to die. In conclusion, I do agree that that assisted suicide breaches human life standards and is not something that is to be compromised just because a human being request to terminate one’s own life.

Works Cited

Beauchamp, Tom L., James F. Childress. Principles of Biomedical Ethics. 7th ed. N.p.: Oxford University Press, 2012. Print.

Thomas, John E., and Wilfrid J. Waluchow. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Toronto: Broadview, 2014. Print.

Background:

This particular case study describes two clinical scenarios, which show a placebo being administered. Case 2 describes a 40-year-old man who is diagnosed with gastroenteritis. The patient reports that he is suffering from diarrhea and abdominal cramps. As the doctor explains to the patient that the symptoms will subside, the wife of the patient demands that the patient be given an injection of penicillin. As the doctor refuses, he insures the wife that he will make another house visit if the symptoms do not subside within 24 hours of him leaving.

Dilemma:

The ethical problem with the placebo is that as it is usually used only for control groups in research studies.  When used in clinical settings the question of whether the patient is being misled if given a placebo or if any harm can come from such usage becomes a concern. As we know the problem is not that the patient is receiving ineffective medicine but it can be useless or produce less desire side effects. Raising the issue that the doctor is deceiving the patient is a violation of the patient’s rights to be honestly and fully informed about the treatment. So the issue here is if it is right for the physician in Case 2 to administer his patient a placebo, if that is what the wife is demanding.

Discussion:

Research has proven that in some cases placebos have resulted in effective therapies, but as discussed previously the problem is the deception and harm the doctor can become responsible for. However, in this particular case, the patient has been advised that the symptoms that he is experiencing will subside with due time. As the doctor has fully assessed him and concluded that prescribing pain medications or an antibiotic is not a necessity in this matter it only would be right for him to do what’s in the patients best interest. But there is a possibility that the suggestion to give an injection may cause the symptoms the patient is experiencing to subside. Now we need to assess if the possibility of this “cure” is worth the doctor trying the placebo. Penicillin is an antibiotic, which is commonly to treat a bacterial infection. However treating with antibiotics for viral infections has no effect on the actual virus and can cause antibiotic resistance. Which is probably why in this situation the doctor chooses not to give an antibiotic.

For these reasons, I do not believe that the administration of the placebo in Case 2 was unethical or a violation of the patient’s rights.  From a professional viewpoint I believe the physicians duty is always to keep the patient out of harms way. So his decision not to administer the penicillin reflects that the physician knew that it was unnecessary. To elaborate the doctor knew that the administration of the unnecessary drug could cause antibiotic resistance for the patient, which can impede on the patient ability to relieve proper care if he is to have a viral infection in the future. As we look at the bigger picture its important to always remember that doctors are always to make sound decisions based on what is best the patients health.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1733989/pdf/v030p00551.pdf

 Background In Case 5.4: Protecting an “Unborn Child,” a young 22 year old girl named “G’ is revealed to be addicted to having a glue as well as other solvents sniffing addiction. “G” addiction has made her incapable of raising children as she has had to relinquished her parental rights for three of her children to family services (Thomas, 201).   The case study describes that the Manitoba Court of Appeal ordered that “G” be released from a treatment facility she was placed in by doctor recommendation. Due to “G’s” doctor’s belief that it was in the unborn child’s best interest to place “G” in a treatment facility and monitor “G” ’s activity on the grounds that every individual has the right to well-being of the individual.

Dilemma  In this particular case the dilemma seems to be rooted in autonomy, which would be whether or the mother’s right to self-determination outweighs the non-maleficence argument which would site that it is the doctors professional job to make sure that the unborn child is protected.  From the autonomy standpoint the mother has the individual ability to govern herself, her body and her choices independent of her place in a metaphysical order or her role in social structures and political institutions (Christman, John) . From the non-maleficence standpoint the choices made by the mother will impact the health of her offspring possibly compromising its health. Understanding both standpoints brings about conversation about a variety of important moral principles, which need to be considered.

Reflection I recognize that my decision may come from my ability to relate to “G” ’s situation, but I would have side with “G” on the matter. Being a feminist the minute I read the case I began think about the issue of women’s autonomy and being able to make decision based on body ownership. “G” owns her physical body and it is completely up to her to make all the decision regarding it.  The author mentions in the case study that women’s rights activist contend that it is a human right more importantly a woman’s right to govern her own bodies will and that she must be offered the strongest possible protection (Thomas, 201).To often in the society we live in insurance companies, husbands, religions, etc. try to control the ownership of this sacred entity that belongs to no one but the physical person. And for these reasons I believe it is only right that “G” make the ultimate decision about the situation at hand.

 Work Cited

Christman, John. “Autonomy in Moral and Political Philosophy.” Stanford University. Stanford University, 28 July 2003. Web. 02 Feb. 2015.

Thomas, John E., and Wilfrid J. Waluchow. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Toronto: Broadview, 2014. Print.