Proceeding Without Consent: The Ethics of Disregarding Patient Preference for Paternalistic Reasons

The last few decades have brought to the medical community a level of accountability that it has never seen prior. Modern medicine’s introduction to patient rights and new regulations focused on respecting patient rights have since left open the question of how to handle scenarios where people who might require treatment but are unable, usually for some reason of cognitive capacity, to express preference or give valid consent to treatment. The intent behind this thesis is to evaluate the ethical nature of forced treatment, specifically in cases of psychological impairment. To do this, it will require an in-depth review and consideration of ‘autonomy’; determine what is required for a person to be considered ‘autonomous’ and discuss when it might be morally permissible to violate an individual’s ‘autonomy.’ This is required so that a solid foundation may be formed in deciding what really is and is not a transgression of an individual’s rights. Furthermore, an evaluation of ethical theory is required, namely, Rights Theory and three ethical principles that are often considered in bioethical determination: beneficence, non-maleficence, and justice. After a review of autonomy is complete, followed by the critiques of the preferred ethical devices, I will then consider the nature of forced treatment and form a conclusion regarding its moral status. Lastly, a proposal will be made considering when and on what grounds Forced Treatment may be deemed a permissible practice despite its non-moral status, with a defense