Patient’s Autonomy and Paternalism: Toward a Covenant Model in Medical Ethics

Edmund 'Dalu Igboanusi


In medical ethics today, there are robust debates on paternalistic practices and patient’s autonomy. Patient autonomy is often at the foundation of many class-action lawsuits when it is perceived that doctors and health care systems take undue advantage of vulnerable patients. Over the years, legal challenges, and financial interests have correspondingly threatened to chase doctors into a reclusive corner. In some Health Care communities, the recourse is to policy schemes that establish “contracts” between the doctor and the patient. Those schemes force a review of moral principles in medical practice and suggest the expediency of strengthening a new covenant model in the doctor/patient relationship. This paper therefore elaborates the concept of autonomy, the weaknesses of paternalism and suggests a shift from legal and contractual approaches in the doctor-patient relationship to a covenant model of doctor-patient relationship that secures, respects and fosters the patient’s autonomy and dignity.

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