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The harm principle, personal identity and identity-relative paternalism

Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does...

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Detalles Bibliográficos
Autor principal: Wilkinson, Dominic
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313974/
https://www.ncbi.nlm.nih.gov/pubmed/36669884
http://dx.doi.org/10.1136/jme-2022-108418
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author Wilkinson, Dominic
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description Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice. In this paper, I explore Derek Parfit’s arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity. Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised.
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spelling pubmed-103139742023-07-02 The harm principle, personal identity and identity-relative paternalism Wilkinson, Dominic J Med Ethics Feature Article Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice. In this paper, I explore Derek Parfit’s arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity. Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised. BMJ Publishing Group 2023-06 2023-01-20 /pmc/articles/PMC10313974/ /pubmed/36669884 http://dx.doi.org/10.1136/jme-2022-108418 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Feature Article
Wilkinson, Dominic
The harm principle, personal identity and identity-relative paternalism
title The harm principle, personal identity and identity-relative paternalism
title_full The harm principle, personal identity and identity-relative paternalism
title_fullStr The harm principle, personal identity and identity-relative paternalism
title_full_unstemmed The harm principle, personal identity and identity-relative paternalism
title_short The harm principle, personal identity and identity-relative paternalism
title_sort harm principle, personal identity and identity-relative paternalism
topic Feature Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313974/
https://www.ncbi.nlm.nih.gov/pubmed/36669884
http://dx.doi.org/10.1136/jme-2022-108418
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