Medical ethics and the two dogmas of liberalism

Abstract
Two dogmas of liberalism in the therapeutic setting are challenged: (1) that patients have a ready-made ability to act autonomously; and (2) that non-intervention by physicians is the best strategy for protecting the autonomy of patients. Recognition of the impact of illness upon autonomous behavior forms the basis of this challenge. It is suggested that autonomy is better conceived as a process of personal growth by which patients become better able to overcome the disruptive effects of illness. The physician is assigned an active role in the achievement of this therapeutic goal. The implications of this new liberal theory are illustrated by reference to the informed consent issue.
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