Who Should Decide? Paternalism in Health Care

James F. Childress examines the ethical tensions between individual autonomy and medical paternalism in healthcare decision-making. The book analyzes cases where healthcare providers must balance respect for patient choices against their professional obligation to promote health and prevent harm. The text presents frameworks for evaluating when paternalistic interventions may be ethically justified in medical contexts. Childress explores specific scenarios involving informed consent, competency assessment, risk disclosure, and treatment refusal. Through detailed philosophical analysis, the work demonstrates how principles of beneficence and respect for persons can come into conflict in clinical settings. The discussion encompasses both theoretical foundations and practical applications for healthcare professionals navigating complex ethical decisions. This influential bioethics text raises fundamental questions about liberty, self-determination, and the proper limits of professional authority in medicine. The examination of paternalism versus autonomy reflects broader societal debates about individual rights and institutional responsibilities.

There appear to be very few public reader reviews available for this 1982 academic text on medical ethics. The book has no ratings or reviews on Goodreads or Amazon. The book is referenced and cited in academic papers and other works about medical ethics and patient autonomy, but substantial reader feedback is limited. What little commentary exists comes from academic reviews in medical and philosophy journals at the time of publication. These academic reviewers noted: Liked: - Clear examination of key concepts around patient autonomy - Balanced discussion of competing principles - Thorough analysis of real medical cases Disliked: - Dense academic writing style - Some repetition in examples - Could have explored cultural differences more deeply Available ratings: Goodreads: No ratings Amazon: No ratings Due to the book's academic nature and age, it appears to have been read primarily in university settings rather than by general audiences.

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🏥 Childress wrote this groundbreaking work in 1982, during a period when medical ethics was emerging as a distinct academic field and patients' rights movements were gaining momentum. 🤔 The book explores conflicts between patient autonomy and medical beneficence through real-world cases, including the landmark case of Karen Ann Quinlan, which helped establish the right to refuse life-sustaining treatment. 📚 James F. Childress went on to co-author "Principles of Biomedical Ethics" with Tom L. Beauchamp, which became one of the most influential textbooks in medical ethics and is now in its eighth edition. ⚖️ The concept of paternalism discussed in the book heavily influenced how modern medical consent procedures evolved, moving away from "doctor knows best" to informed patient choice. 🎓 The author holds both a Ph.D. in religious ethics and an M.A. in theology, bringing a unique perspective to medical ethics that combines philosophical, religious, and practical considerations.