SMA Ethics Winning Essay 2001 (Non-Medical Undergraduate Category) Deconstructing Paternalism - What Serves the Patient Best?

NHSS Tan
Correspondence: Noel Hidalgo Tan Suwi Siang, noelbynature@pacific.net.sg

ABSTRACT
On the motion that "medical paternalism serves the patient best", this essay reviews current arguments on medical paternalism vs. patient autonomy. Citing medico-ethical texts and journals and selected real-life applications like electroconvulsive therapy (ECT) and the advanced medical directive (AMD), the essay argues that medical paternalism cannot serve the patient best insofar as current debates limit themselves to "who" wields the decision-making power. Such debates side-step "what" the patient's best interests are. The essay further argues through the case of Traditional Chinese Medicine (TCM), and acupuncture in particular, that the current dominant Western school of thought excludes other forms of "alternative" treatment through medical paternalism.

Singapore Med J 2002; 43(3): 148-151