The Relationship between Paternalism and Autonomy in Medicine from an Ethical and Legal Viewpoint

Abstract: Introduction: The terms autonomy and paternalism can be conceptualized and analyzed from different perspectives. The most relevant for physicians in this study are the ethical and legal viewpoints. In order to conceptualize anything a definition to depart from is needed, in this case from Oxford’s dictionaries. The importance to reflect on ethical and legal matters as a physician is due to the power over the patient one has, and it must be respected and grounded in a motivated ethical principle, since all our actions arise from ethics, consciously and subconsciously. Aim: The aim is to analyze and discuss the relationship between paternalism and autonomy from a medical ethical perspective, in relevant Swedish laws and with regards to the ethical principles. Methods: This is a qualitative study on hermeneutic ground that used two different databases and libraries and sorted material according to relevance. Inevitably this leads to a bias due to the author’s previous knowledge and selected sources. Results, Discussion and Conclusion: Physicians tend to prioritize ethical arguments depending on the situation. Autonomy is one of the four ethical principles, and this is not always the most prioritized, but beneficence may be seen as a stronger argument for action. Also, there are more regulations to secure the patient’s autonomy than the physician’s paternalism, leading to only indirect regulations towards paternalism. The conceptualization of paternalism and autonomy can be seen in many different ways, and are not always opposites as it can initially seem, but in some scenarios aline.