A defence of medical paternalism : A defence of inedical paternalismn : maximising patients ' autonomy

All illness represents a state ofdiminished autonomy and therefore the doctor-patient relationship necessarily and justifiably involves a degree ofmedical paternalism argues the author, an American medical student. In a broadranging paper he discusses the concepts ofautonomy and paternalism in the context of the doctor-patient relationship. Given the necessary diminution ofautonomy which illness inflicts, a limitedform ofmedical paternalism, aimed at restoringormaximisingthe patient's autonomy is entirely acceptable, and indeed fundamental to the relationship he argues. However, the exercise ofthis patentalism should be flexible and related to the current 'level ofautonomy' of the patient himself. An editorial in this issue comments briefly on this paper.