Analysis of Paternalistic Approach to Truth-Telling in Medicine

This essay provides a critical analysis of the paternalistic approach to truth-telling in healthcare, examining the ethical and legal frameworks that govern medical practice. It delves into the concept of paternalism, where healthcare providers may make decisions in the patient's best interest, even without explicit consent, and explores the justifications for such approaches, including protecting patients from harm and providing optimal health benefits. The essay discusses the ethical principle of autonomy and its limitations, highlighting instances where paternalism is considered justifiable, such as when a patient ingests poison or when confidentiality must be breached to protect others from infectious diseases. It also covers court orders that may require breaching patient confidentiality. The essay concludes by emphasizing the complexities of balancing patient autonomy with the healthcare provider's responsibility to ensure safety and well-being, ultimately arguing that paternalistic interventions are ethically justifiable under specific circumstances.

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Patient Confidentiality and Paternalistic Approach to Truth-Telling in Medicine
Introduction
Health care is a fully-fledged discipline that is governed by ethics and legislations. This
means that the healthcare providers should not operate the way they want, but do so in a strict
compliance with well-outlined ethical and legal regulations. All these are put in place to
guarantee the safety, efficiency, and quality of the services especially for the benefit of the
patients. Paternalistic approach to truth-telling is one of the main regulations that must always be
adhered to. The healthcare providers are free to choose to violate the patient’s autonomy or
liberty rights under the pretext of the paternalistic approach. It is important because they serve
the interests of the patients. This paper presents a critical ad in-depth analysis of the essence of
the application of the concepts of paternalistic approach to truth-telling in healthcare service-
delivery.
Paternalistic Approach to Truth-Telling in Medicine
Paternalism is a situation in which the healthcare providers offer services without their
consent. In health care, there is an ethical principle of autonomy. It requires that the patient
should enjoy some rights that allow them to take part in making decisions regarding the services
that they acquire. Ethically, all the healthcare providers should guarantee autonomy rights to the

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patients. However, autonomy is not an absolute right because it can be lawfully and ethically-
violated. The paternalistic approach mandates the healthcare providers to go ahead and offer
medication, procedure, diagnosis, assessment or treatment without seeking the approval of the
patient.
Paternalism is justifiable in health care because it can help in protecting the patient from
any harm. As a matter of fact, the healthcare providers should be responsible for the provision of
safe and harm-free services to their patients. This indicates that the healthcare providers should
be responsible for the safety of the patients who are under their care (Gigerenzer 366). So, even
if he patients are entitled to autonomy, the practitioner can apply the paternalistic approach of
truth-telling to come up with a new decision that is against their wish. The decision should be
ethically justifiable if done with the purpose of protecting the patent from any harm that might be
endured (Murgic, et al. 65. An example of an incident that can serve as a case scenario in this
section is when the healthcare provider decided to treat a patient who had ingested a poisonous
substance against his will. If a patient ingests poisonous substances, it is obvious that the
intention is to commit suicide. In scenario, the practitioner should go against the patient’s wishes
by offering an immediate medical intervention that can neutralize the effects of the poison s as to
prevent the patient from dying or suffering even if that was his sole intension. Should this
happen, the practitioner should be commended because the action is ethical. It provides a
solution to the problem of self-harm that the patient had been misled to do.
Paternalism is also justifiable in health care since it can bring strong health benefits to a
patient. Under this approach, patients are presumed to be lay-people who do not have a sound
knowledge of the implications of decisions they make regarding their health. As lay-people,
patients are likely to make decisions that can end up interfering with their lives. This is why the

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healthcare providers are, at times, justified to go against the wishes of the patients (Rosenbaum
739). There are many instances in which the medics have applied this approach when handling
their patients. One example that serves as a case study in this paper is when a healthcare provider
made a decision to amputate a patient’s even though the patient was against that. After a
thorough examination and assessment of the patient’s conditions, the patient made a decision
amputate both the two legs. The practitioner was doing this for the best benefits of the patient.
He had to do this even if the patient had refused that he did not want to be considered as a
disabled person. Also, the patient was not interested in using the wheel chair or becoming
immobile. However, to the practitioner, the patient had to be amputated and supported to the
prosthesis to move around.
Paternalistic approach can be used by the medical providers in pursuit of providing
protection to other people. The practitioner can violate the patient’s confidentiality in other to
protect other people from harm. There are diseases which can be easily spread from one patient
to the other. So, in order to curtail the spread, the practitioner should inform those at risk. For
example, if a patient who is diagnosed with the HIV virus, the medic can inform the sexual
partner/spouse even if that particular patient does not want to do so. This action is justified
because it can be protective. One of the major duties of a healthcare provider is to offer a harm-
free service. The other is to provide a benevolent and safe care to the patients. To do this, the
healthcare providers can be compelled to breach the patient’s confidentiality rights (Bourgeois,
Daniel and Marvin 13). This can, therefore, be done on two grounds. The healthcare providers
are also allowed to breach the patient confidentiality in case of an outbreak of an infectious
disease. The government authorizes the practitioners to collect epidemiological information on
various infectious diseases and submit the data to the relevant statutory bodies. Such data is

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important because they are used to study the pattern of infectious diseases and come up with
appropriate preventive and mitigation measures. This implies a healthcare provider who gives
such otherwise private patient information would not be regarded to have breached the
confidentiality standards Tucker, et al. 77).
The healthcare providers are permitted to apply the paternalistic approach to truth-telling
to deliberately cheat patients in case of an authorization by a court order. The healthcare
providers can violate the patients’ autonomy rights in case of a court order. Court is one of the
arms of the government. It plays a significant role in the administration of justice-related matters.
These include the interpretation of laws and the issuance of judgment on all matters in the
country. In Canada, the healthcare sector works hand in hand with the courts. The court can give
the healthcare providers an opportunity to breach the patients’ confidentiality rights (Williams, et
al. 6). This can be done by the giving out of orders whenever a need arises. A court can, for
instance, order the practitioner to share or leak some private health information to other parties.
This is not a new thing because it is an old practice that has been going on in the country for a
very long time. However, all the court orders should be given out for the best interest of the
patient, loved ones, family members or the public in general. It should be the responsibility of
the practitioner to ensure that there is a strong compliance.
Paternalistic approach to truth-telling is, indeed, a complicated concept. Many people
think that it is unethical because it involves the violation of the patient’s liberty rights. However,
to apply it, the healthcare provider should engage in a number of activities. First, the medic can
choose to be deceptive. Meaning, the medic can cheat the patent and provide him or her with
wrong and misleading information (Fernández-Ballesteros, et al 1460). Deception is applicable
when the patient has a contrary opinion that is not acceptable by the provider. The other tactic to

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adopt when applying the approach is the manipulation of the consent. The manipulation of the
consent can be done for many purposes such as harming, disabling, and killing. Harm can occur
if a patient is gets an intervention or procedure against his or her wish. Disability, on the other
hand, can take place in case the patient is amputated without consent. Although such
manipulations are ethically-justifiable, there are some people who hold the view that they are
unjustified violations.
Conclusion
Autonomy is a liberty right that everyone is entitled to by the constitution. The healthcare
providers are ethically justified to breach the patient’s autonomy whenever necessary. The law
mandates the healthcare providers to breach the patients’ autonomy in case of a court order,
infectious diseases, and creation of a harm-free service to the patients. The principle of
paternalism can also be applied when dealing with patients. The health practitioners are
justifiable to treat the patients without seeking their consent as long as the decisions is aimed to
benefit the patient by protecting them from harm and proving a safe and satisfactory service to
them. So, even if the patients insist that they have rights over their private health information, the
healthcare providers are justified to use the paternalistic approach to violate their liberty rights by
using their powers to make contrary decisions.

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Works Cited
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confidentiality in the era of personal health records." Pediatrics 135.5 (2015): 1-17.
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Fernández-Ballesteros, Rocío, et al. "Paternalism vs. Autonomy: Are they alternative
types of formal care?." Frontiers in Psychology 10 (2019): 1460.
Gigerenzer, Gerd. "On the supposed evidence for libertarian paternalism." Review of philosophy
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Murgic, Lucija, et al. "Paternalism and autonomy: views of patients and providers in a
transitional (post-communist) country." BMC medical ethics 16.1 (2015): 65.
Rosenbaum, Lisa. "The paternalism preference—choosing unshared decision making."
Obstetrical & Gynecological Survey 70.12 (2015): 739-740.
Tucker, Katherine, et al. "Protecting patient privacy when sharing patient-level data from clinical
trials." BMC medical research methodology 16.1 (2016): 77-84.
Williams, Hawys, et al. "Dynamic consent: a possible solution to improve patient confidence and
trust in how electronic patient records are used in medical research." JMIR medical
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