Exam 1 - Part I (Models of the Physician-Patient Relationship & Paternalism)

What, according to the Emmanuels, are the main distinguishing characteristics of the four models of the physician-patient relationship? (Know them well enough so that you can correctly identify which model is being displayed when particular physician-patient interactions are described.)

What is medical paternalism, and what is the distinction between weak medical paternalism and strong medical paternalism?

What, according to Goldman, do proponents of medical paternalism presume patients value more than anything else?

Goldman gives two arguments pertaining to the social policy level which allegedly show that medical paternalists should not presume what they do about a patient’s rational ordering of values. In a PowerPoint presentation, I put these two arguments in the form of modus tollens (or denying the consequent):

i. If p, then q.

ii. Not q.

iii. Therefore, not p.

What is one of these two arguments

Goldman goes further than faulting medical paternalists for presuming what is at the top of a patient’s ordering of values; he makes a case for the freedom to make important decisions about one’s life (i.e., self-determination or autonomy) as being at the top of that list. What is one example he gives in support of the view that people in general (and hence patients in particular) place autonomy at the top of their ordering of values?

At the end of his essay, Goldman gives a second argument in support of the “super-value” of autonomy that, unlike his first argument, is independent of what people as a matter of fact value. (In the parlance of moral philosophy, such independence makes the argument “ideal-regarding” or “perfectionist.”) What is this second argument in support of the super-value of autonomy?

If health care professionals view autonomy as a threshold concept only, then what, on Terrence Ackerman’s view, is respect for patient autonomy likely—and inadequately—going to amount to?

If, on the other hand, health care professionals come to appreciate that autonomy is a matter-of-degree phenomenon, then what, on Ackerman’s view, is respect for patient autonomy likely—and more adequately—going to involve?

Ackerman views the physician with a seriously ill patient as a kind of detective with a particular end in mind. What, on Ackerman’s view, should such a physician, as detective, try to uncover and deal with?

Does Ackerman support medical paternalism? If so, why? If not, why not?