Presentation Title: “A study on the permissibility of paternalism in the medical field in Korea”

Abstract:

This study argues that the problem of paternalism in Korea can occur not only in the medical doctor-patient relationship, but also in the family guardian-patient relationship, which it raises an ethical consideration when patient makes a decision in medical intervention. The problem of paternalism in clinical setting refers to the question of whether it is permissible to constrain the autonomy of patient in order to give the best interest for the patient. In the field of medical ethics, this issue has been generally discussed in the relationship of medical doctor-patient in that the medical doctor's judgment may not respect the autonomy of patients. In this study, however, I would like to point out that in the case of Korea, the problem of paternalism can also occur by family guardian of patient. According to Korean practices, the opinions of family guardians are reflected positively in medical decision-making process. And if the family guardian’s judgement differ from the patient’s own, autonomy of the patient may be constrained by his family guardian. In particular, respecting and concerning for the elderly parents, child of the old patient, as family guardian, may get the medical information of their parents and not deliver it to the patient. Interestingly, those paternalistic behaviors of the guardian may sometimes be emotionally approved by other people who get those news. It shows that the paternalism may be permissible in the context of family guardian-patient relationship, despite the Autonomy Principle, when especially the relationship is between parenthood and childhood. Therefore, this study aims to review the problem of paternalism mentioned above and find out whether respecting autonomy of patient and allowing paternalistic behavior of elderly parent’s child is compatible. Accordingly, this study will review the problem of paternalism in the medical ethical fields, and try to apply it to the relationship of family guardian and patient in the aspect of Korean context. Then I will examine the conditions for allowing paternalistic behavior in the relationship. Finally, I will present that respecting for autonomy of patient and allowing for paternalistic behavior of family guardian is compatible in certain conditions, especially in Korean cultural context.