title: Market liberalism in health care: a dysfunctional view of respecting "consumer" autonomy.
abstract: The unfortunately vast history of paternalism in both medicine and clinical research has resulted in perpetually increasing respect for patient autonomy and free choice in Western health care systems. Beginning with the negative right to informed consent, the principle of respect for autonomy has for many patients evolved into a positive right to request treatments and expect accommodation. This evolution of patient autonomy has mirrored a more general social attitude of market liberalism where increasing numbers of patients have come to embody the role of the "consumer." This paper explores this transformation and critiques the current way in which respect for patient autonomy is put into practice. Ultimately, this paper concludes that the consumer view of patient autonomy is dysfunctional. Moreover, this paper argues that, based on the inherent goals of medicine, some form of paternalism is required in any meaningfully therapeutic relationship.
authors.affiliation: Department of Clinical and Organizational Ethics, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada, mkekewich@toh.on.ca.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kekewich
mesh_terms: D002170:Canada; D002755:Choice Behavior / Q000941:ethics; D003657:Decision Making / Q000941:ethics*; D026689:Ethical Analysis; D028663:Ethical Theory; D004992:Ethics, Medical; D019981:Health Care Sector / Q000941:ethics; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D026706:Paternalism / Q000941:ethics; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D011057:Politics; D014481:United States