Stan N H S S
Ngee Ann Polytechnic.
Singapore Med J. 2002 Mar;43(3):148-51.
On the motion that "medical paternalism serves the patient best", this essay reviews current arguments on medical paternalism vs. patient autonomy. Citing medico-ethical texts and journals and selected real-life applications like electroconvulsive therapy (ECT) and the advanced medical directive (AMD), the essay argues that medical paternalism cannot serve the patient best insofar as current debates limit themselves to "who" wields the decision-making power. Such debates side-step "what" the patient's best interests are. The essay further argues through the case of Traditional Chinese Medicine (TCM), and acupuncture in particular, that the current dominant Western school of thought excludes other forms of "alternative" treatment through medical paternalism.
围绕“医学家长主义最有利于患者”这一观点，本文回顾了当前关于医学家长主义与患者自主权的争论。通过引用医学伦理文本、期刊以及电休克疗法（ECT）和预立医疗指示（AMD）等选定的现实生活应用案例，本文认为，就当前的争论局限于“谁”掌握决策权而言，医学家长主义并非最有利于患者。此类争论回避了患者的“最佳利益是什么”这一问题。本文还通过中医，尤其是针灸的案例进一步论证，当前占主导地位的西方思想流派通过医学家长主义排除了其他形式的“替代”疗法。
