The ethical dilemma surrounding medical paternalism is something that has attracted arguments from various authors. Goldman is one such author whose argument on medical paternalism has attracted both proponents and opponents in equal measure. The author claims that it is wrong to assume that health and prolonged life are the top priorities amongst the patient's preferences. The conclusion of the author is his determination that medical paternalism is wrong and asserts that if individuals really valued life, then they would put all their efforts in life supporting areas. The author concludes that it is not logical for the doctor to establish what is best for the patient since the doctor is not in a position to know the priorities and set of values of the patient.
Whereas the doctor may hold the patient's health as the first priority, this may not be the case for the patient at all times. Goldman brings the idea of self-determination and argues that the patient has an absolute freedom to make choices based on the patient's interest. He argues that since the doctor does not have the knowledge of the patient's self-interest, it is unlikely for the doctor to make the right decision for the patient. If the doctor makes a decision which is not in the best interest of the patient, then it cannot be said that such a decision is right even if it supports life.
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The form of argument is a moral argument. While one can argue in defense of medical paternalism that the doctor is in the best position to do what is best for the patient regarding health, I concur with Goldman that it is difficult to ascertain the best interest of the patient since the doctor does not know the set of values or priorities of the patient. For instance, if the doctor determines that the patient is in need of blood and has to undergo blood transfusion, the patient may be a follower of Jehovah Witness and does not believe in blood transfusion. Therefore a doctor may have an idea of what is best for the patient, but it the choice of the patient to comply or not.
