title: Medical maternalism: beyond paternalism and antipaternalism.
abstract: This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians' non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to decide for another person based on a reasonable understanding of that person's own preferences. The concept of maternalism allows for a more thorough assessment of the moral justification of these types of actions. I conclude that it is possible, at least in principle, to justify Japanese physicians' non-disclosures, and that this justification must be based on an understanding of these actions as maternalistic.
authors.affiliation: Center for Sensorimotor Neural Engineering, University of Washington, Seattle, Washington, USA National Core for Neuroethics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Specker Sullivan
mesh_terms: D001291:Attitude of Health Personnel; D026686:Beneficence; D003657:Decision Making; D006801:Humans; D007564:Japan; D026706:Paternalism / Q000941:ethics; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000523:psychology; D017009:Professional Autonomy; D014342:Truth Disclosure / Q000941:ethics
keywords: Cultural Pluralism; Decision-making; Informed Consent; Paternalism; Truth Disclosure