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1

The limits of medical paternalism. London: Routledge, 1991.

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2

American Enterprise Institute for Public Policy Research., ed. Medicare private contracting: Paternalism or autonomy? Washington, D.C: AEI Press, 1998.

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3

Nikku, Nina. Informative paternalism: Studies in the ethics of promoting and predicting health. Linköping: Dept. of Health and Society, Linköping University, 1997.

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4

Guillod, Olivier. Le consentement éclairé du patient: Autodétermination ou paternalisme? Neuchâtel [Switzerland]: Impr. P. Attinger, 1986.

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5

The silent world of doctor and patient. New York: Free Press, 1986.

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6

Bedside manners: The troubled history of doctors and patients. New York: Simon and Schuster, 1985.

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7

Shorter, Edward. Bedside manners: The troubled history of doctors and patients. Harmondsworth: Viking, 1986.

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8

Shorter, Edward. Bedside manners: The troubled history of doctors and patients. New York: Simon and Schuster, 1985.

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9

Hyry, Heta. Limits of Medical Paternalism. Taylor & Francis Group, 2014.

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10

Häyry, Heta. The Limits of Medical Paternalism. Routledge, 2002. http://dx.doi.org/10.4324/9780203161050.

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11

Coulter, Angela. The Autonomous Patient: Ending Paternalism in Medical Care. Stationery Office, 2002.

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12

The Autonomous Patient: Ending Paternalism in Medical Care. Stationery Office, 2002.

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13

Flanigan, Jessica. Paternalism and Public Health. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190684549.003.0002.

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Since medical paternalism is wrong in the clinical context, it should be rejected in public policy as well. But even if paternalistic public health policies were permissible, it is not clear that prohibitive pharmaceutical regulations are necessary to promote public health. Prohibitions could undermine health in some cases, for example, if prescription requirements make patients more deferential to physicians and tolerant of medical risks. Premarket testing requirements cause people to suffer and die waiting for new drugs to get approved, and they discourage new drug development. This is not to say that regulation serves no purpose. Pharmaceutical regulators provide a valuable pubic good by overseeing testing for new drugs and by certifying drugs that they deem generally safe and effective. But the benefits of regulation do not require that the regulations be prohibitive, and prohibitive regulations not only violate patients’ rights, they may also cost lives.
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14

Who Should Decide?: Paternalism in Health Care. Oxford University Press, USA, 1985.

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15

Thomas, Nys, Denier Yvonne, and Vandevelde Toon, eds. Autonomy & paternalism: Between independence and good intentions. Leuven: Peeters, 2007.

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16

Historical and Philosophical Perspectives on Biomedical Ethics: From Paternalism to Autonomy? Routledge, 2019.

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17

Geyer-Kordesch, Johanna, and Andreas-Holger Maehle. Historical and Philosophical Perspectives on Biomedical Ethics: From Paternalism to Autonomy? Taylor & Francis Group, 2017.

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18

Jr, Staffieri Michael, and Janet Farrell Leontiou. Doctor Still Knows Best: How Medical Culture Is Still Marked by Paternalism. Lang AG International Academic Publishers, Peter, 2020.

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19

Strain, James J., and Rosamond Rhodes. Medical-Surgical Psychiatry and Medical Ethics. Edited by John Z. Sadler, K. W. M. Fulford, and Cornelius Werendly van Staden. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780198732365.013.23.

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Consultation-liaison Psychiatry is the newest sub-specialty in psychiatry. It focuses on the psychological/psychiatric care of medical, surgical, obstetrical, and gynecological patients and presents many distinctive ethical dilemmas. These dilemmas often involve judgments of capacity and justified paternalism, manifest versus latent content, surrogate decision making, confidentiality, truth telling, dual agency, refusing treatment, decisions to end life, surrogate decision-making, and the complexity of interdisciplinary moral relationships. This interface between psychiatry, medicine, and ethics highlights the need for bioethical teaching within medical school, residency, and fellowship education. Ethical reasoning needs to be in the repertoire of the contemporary physician especially now, given the rapidly expanding choices that must be made in today’s medicine. This chapter provides examples of ethical dilemmas that arise in Consultation/Liaison Psychiatry and illustrations of the ethical analysis that can be used to resolve them.
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20

(Editor), Thomas Nys, Yvonne Denier (Editor), and Toon Vandevelde (Editor), eds. Autonomy and Paternalism: Reflections on the Theory and Practice of Health Care (Ethical Perspectives Monograph Series). Peeters, 2007.

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21

(Editor), Andreas-Holger Maehle, and Johanna Geyer-Kordesch (Editor), eds. Historical and Philosophical Perspectives on Biomedical Ethics: From Paternalism to Autonomy? (Ashgate Studies in Applied Ethics). Ashgate Publishing, 2002.

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22

Flanigan, Jessica. Pharmaceutical Freedom. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190684549.001.0001.

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If a competent adult refuses medical treatment, physicians and public officials must respect her decision. Coercive medical paternalism is a clear violation of the doctrine of informed consent, which protects patients’ rights to make medical decisions even if a patient’s choice endangers her health. The same reasons for rejecting medical paternalism in the doctor’s office are also reasons to reject medical paternalism at the pharmacy. Yet coercive medical paternalism persists in the form of premarket approval policies and prescription requirements for pharmaceuticals. This book defends patients’ rights of self-medication. It argues that public officials should certify drugs instead of enforcing prohibitive pharmaceutical policies that disrespect people’s rights to make intimate medical decisions and prevent patients from accessing potentially beneficial new therapies. This argument has revisionary implications for important and timely debates about medical paternalism, recreational drug legalization, human enhancement, prescription drug prices, physician assisted suicide, and pharmaceutical marketing. The need for reform is especially urgent as medical treatment becomes increasingly personalized and patients advocate for the right to try. The doctrine of informed consent revolutionized medicine in the twentieth century by empowering patients to make treatment decisions. Rights of self-medication are the next step.
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23

Zabielska, Magdalena. Searching for the Patient's Presence in Medical Case Reports. Lang GmbH, Internationaler Verlag der Wissenschaften, Peter, 2014.

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24

Zabielska, Magdalena. Searching for the Patient's Presence in Medical Case Reports. Lang GmbH, Internationaler Verlag der Wissenschaften, Peter, 2014.

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25

Zabielska, Magdalena. Searching for the Patient's Presence in Medical Case Reports. Lang GmbH, Internationaler Verlag der Wissenschaften, Peter, 2014.

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26

Zabielska, Magdalena. Searching for the Patient's Presence in Medical Case Reports. Lang Publishing, Incorporated, Peter, 2014.

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27

Zabielska, Magdalena. Searching for the Patient's Presence in Medical Case Reports. Lang GmbH, Internationaler Verlag der Wissenschaften, Peter, 2014.

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28

Bob, Hepple, and Nuffield Council on Bioethics, eds. Public health: Ethical issues. London: Nuffield Council on Bioethics, 2007.

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29

King, Steven. Sickness, medical welfare and the English poor, 1750-1834. Manchester University Press, 2018. http://dx.doi.org/10.7228/manchester/9781526129000.001.0001.

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This book explores the welfare experiences of the sick poor between the 1750s and through the so-called crisis of the Old Poor Law ending in the 1830s. It brings together a large dataset of accounts, vestry minutes, bills, contracts and letters by or about the poor to provide a comprehensive and colourful overview of the nature, scale and negotiation of medical welfare. At its core stand the words and lives of the poor themselves, reconstructed in painstaking detail to show that medical welfare became a totemic issue for parochial authorities by the 1830s. The book suggests that the Old Poor Law confronted a rising tide of sickness by the early nineteenth century. While there are spectacular instances of parsimony and neglect in response to such rising need, in most places and at most times, parish officers seem to have felt a moral obligation to the sick. Indeed, we might by and large construct their responses as considerate and generous. To some extent this reflected Christian paternalism, but we also see other factors at play. These include a growing sense that illness, even illness amongst the poor, was and should be remediable and a shared territory of negotiation between paupers, advocates and officials. The result was a canvas of medical welfare with extraordinary colour and depth. By the 1820s, more of the ill-health of ordinary people was captured by the poor law and being doctored or sojourning in an institution became part of pauper and parochial expectation. These trends are brought to vivid life in the words of the poor and their advocates, such that the book genuinely offers a re-interpretation of the Old Poor Law in it slater phases form the bottom up.
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30

Miller, Richard B. Children, Ethics, and Modern Medicine (Medical Ethics). Indiana University Press, 2003.

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31

Flanigan, Jessica. A Defense of Self-Medication. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190684549.003.0001.

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The same considerations that justify rights of informed consent also justify rights of self-medication because paternalism is wrong at the pharmacy and in the doctor’s office. Rights of self-medication require that patients have legal access to medicines without a prescription and without authorization from a regulatory agency. Like informed consent, the right of self-medication does not rely on a single, potentially controversial normative premise. From a consequentialist perspective, patients should be entrusted with making choices for themselves because they are generally most knowledgeable about which decision will further their interests. From a rights-based perspective, medical decisions are often intimate and personal choices that are especially significant to patients. Furthermore, even if a medical choice is not intimate, personal, or especially significant, people are more generally entitled to choose how they live their lives without being subjected to benevolent interference by physicians or public officials.
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32

Szmukler, George. Challenges to the orthodoxy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198801047.003.0004.

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Two comparatively recent developments in health care ethics and policy further challenge the conventional bases for involuntary treatment in mental health care. First has been the shift in general medicine over the past 50 years from ‘paternalism’ and large medical discretion to patient ‘autonomy’. Interventions require ‘informed consent’; treatment without a patient’s consent can only occur if the person lacks ‘decision-making capacity’ and the treatment is judged to be in the person’s ‘best interests’. The treatment decision of a general medical patient who has decisional capacity is respected even if it appears to be unwise. This shift to respect for patient self-determination has been largely ignored in psychiatry. The second policy development is the extension in mental health care of involuntary treatment into the community, greatly increasing the scope for the exercise of compulsion. What constitutes an appropriate level of risk to justify compulsion in the community is unclear.
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33

Katz, Jay. The Silent World of Doctor and Patient. The Johns Hopkins University Press, 2002.

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34

Hinshelwood, R. D. Projection and Introjection. Edited by John Z. Sadler, K. W. M. Fulford, and Werdie (C W. ). van Staden. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780198732372.013.34.

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Psychiatry straddles a medical approach to the mentally ill, and a dynamic approach to the experiences of severely disturbed people. One consequence of this is that ethical principles apply in different ways. The understanding of processes known as introjection, projection, and splitting seriously disrupt the functioning of a person and his ability to make adequate, responsible decisions. Severe mental illness can be regarded as the disruption of a moral agent, and in a sense treatment has to focus on the resumption of those functions that enable the person to take responsibility again. This chapter explores the ethics of the person’s loss of his personal functioning. Paternalism does not have a free rein, and needs to be carefully used as it supplants autonomy. Over-extended paternalistic care leads to excessive depletion of the patient, and was apparent in the old mental hospital as it still is in contemporary community care as specific organizational dynamics.
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35

Samanta, Jo, and Ash Samanta. 9. The end of life. Oxford University Press, 2018. http://dx.doi.org/10.1093/he/9780198815204.003.0009.

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Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. This chapter deals with key legal and ethical issues surrounding end-of-life decisions, with particular reference to physician-assisted death such as euthanasia. Suicide and assisted suicide, administration of pain relief, and futility are considered. Relevant legislation such as the Suicide Act 1961 (as amended by the Coroners and Justice Act 2009), the Human Rights Act 1998, and the Mental Capacity Act 2005 are discussed. The chapter examines several bioethical principles, including sanctity-of-life and quality-of-life debates; autonomy, beneficence, and medical paternalism; personhood, palliative care, and the double effect doctrine. Finally, it considers human rights issues, treatment requests, incompetent patients, and the concept of the minimally conscious state and locked-in syndrome. Recent cases are cited.
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36

Saracino, Rebecca, Melissa Masterson, and Barry Rosenfeld. The Impact of Depression on Health Care Decisions. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198801900.003.0016.

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This chapter examines how depression affects health care decisions, with particular emphasis on patient autonomy, capacity, and competence for decision-making. It first considers the ethical boundaries and psycho-legal criteria for assessing decision-making capacity in the context of medical treatment decisions, attending to issues of autonomy and beneficence as well as the debate over whether paternalistic approaches have a place in our health care system. It then discusses the parameters that help define the debate over paternalism, along with the clinical challenges that accompany the assessment and implementation of these alternative approaches to health care decision-making. The chapter also reviews research exploring the impact of depressive symptoms on decision-making capacity and treatment refusal more specifically. It cites the doctrine of informed consent, the goal of which is to promote patient autonomy and rational decision-making. The chapter concludes with recommendations for a comprehensive approach to decision-making capacity assessment and directions for future research.
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37

Veatch, Robert M., Amy Haddad, and E. J. Last. Death and Dying. Edited by Robert M. Veatch, Amy Haddad, and E. J. Last. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190277000.003.0018.

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Many of the critical moral decisions related to the care of terminally and critically ill patients actually involve the ethical issues of informed consent or the refusal and withdrawal of consent. Legal as well as most ethical theories consider the moral principle of autonomy to take priority over paternalism. If this is true, then it is acceptable for the substantially autonomous patient, even if treatment is life-sustaining, to decline or to withdraw consent. This chapter begins with the problems associated with definitions of death. In succeeding sections, the cases deal with decisions by surrogates for terminally or critically ill patients who are not competent to make their own choices, looking first at formerly competent patients and then at those who have never been competent. In the final section, the issue is new controversies over limiting the amount of care that is provided to terminally ill patients in order to conserve scarce medical resources.
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38

Bedside Manners: The Troubled History of Doctors and Patients. Simon & Schuster, 1987.

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39

Szmukler, George. Men in White Coats. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198801047.001.0001.

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The book examines medical treatment under coercion and its justifications. Psychiatry springs to mind as most associated with coercion. Here, the fundamental criteria governing detention and involuntary treatment have remained fundamentally unchanged for over two centuries—first, the person has a ‘mental disorder’, largely undefined; and second, there is a risk of significant harm to the person or to others. Major problems attach to these criteria allowing a large degree of arbitrariness in the use of compulsion. Furthermore, when set against the huge shift over the past 50 years from ‘paternalism’ to patient ‘autonomy’ in general medicine, it becomes clear that conventional mental health law discriminates against people with ‘mental disorders’. Involuntary treatment is governed by entirely different principles. Patient ‘autonomy’ is not accorded the same respect in mental health care, while the ‘protection of others’ justification, based on ‘risk’ not offences, constitutes a discriminatory form of preventive detention reserved for people with ‘mental disorders’. A solution is proposed—a generic law, applicable across all medical specialties and settings. This ‘Fusion Law’ draws on the strengths of both ‘capacity-based’ and civil commitment models. The relationships of ‘capacity’ and ‘best interests’ to a person’s ‘beliefs and values’ (or ‘will and preferences’) are elucidated in order to examine the ‘Fusion Law’ against the standards set by the United Nations Convention on the Rights of Persons with Disabilities. ‘Coercion’ short of compulsion is then considered, as are the implications of the ‘Fusion Law’ for the forensic domain, general hospital practice, involuntary outpatient treatment, and ‘advance directives’.
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40

Wear, Andrew, and Johanna Geyer-Kordesch. Doctors And Ethics: The Historical Setting Of Professional Ethics.(Clio Medica/The Wellcome Institute Series in the History of Medicine 24) (Clio Medica ... Institute Series in the History of Medicine). Rodopi, 1993.

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41

1946-, Wear A., Geyer-Kordesch Johanna, and French R. K, eds. Doctors and ethics: The earlier historical setting of professional ethics. Amsterdam: Rodopi, 1993.

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42

Refusing Care: Forced Treatment and the Rights of the Mentally Ill. University Of Chicago Press, 2002.

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