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Applied Ethics Forum: Allison McCarthy
November 18, 2019 @ 4:00 pm - 6:00 pm
Allison McCarthy (UCLA Health Ethics Center)
‘Doctor, shield thyself: defending medical partnership against patient autonomy’
Monday 18 Nov 2019 • 4:00pm–6:00pm • UTC–101
Abstract: In his review of Robert Veatch’s Patient, Heal Thyself, Sherwin Nuland alleged that Veatch ‘is desperate to wrest authority from the hands of the doctor’. Nuland’s claim echoes several decades of complaints that patient autonomy has gone too far in its impact on the ideal of the doctor-patient relationship. Doctors and patients should be viewed as distinct and equally important partners in medical decision-making, these critics argue; insisting that doctors should simply defer to patient choices, or even values, reflects a misguided fixation on patient autonomy. However, very few arguments provide a compelling defense of this partnership, and almost all fall back on assumptions regarding the unrealism of substantial patient autonomy. In this talk, I offer a defense of the doctor as a distinctive deliberative partner. Allowing the doctor to push back on patient choices is important in order for doctors to function as patient health advocates. Given the prevalence of material and social pressures that encourage patients to de-emphasize their health in their own deliberation, the role of doctors (and other health care providers) as patient health advocates is important in protecting patient well-being. I conclude by addressing the concern that the defense of the doctor as a patient health advocate reintroduces to the doctor/patient relationship an objectionable kind of paternalism.