O'Neill O
J Med Ethics. 1984 Dec;10(4):173-8. doi: 10.1136/jme.10.4.173.
A contrast is often drawn between standard adult capacities for autonomy, which allow informed consent to be given or withheld, and patients' reduced capacities, which demand paternalistic treatment. But patients may not be radically different from the rest of us, in that all human capacities for autonomous action are limited. An adequate account of paternalism and the role that consent and respect for persons can play in medical and other practice has to be developed within an ethical theory that does not impose an idealised picture of unlimited autonomy but allows for the variable and partial character of actual human autonomy.
人们常常在标准的成年人自主能力(这种能力允许给予或拒绝知情同意)与患者降低的自主能力(这种能力需要家长式的治疗)之间进行对比。但患者可能与我们其他人并没有根本的不同,因为所有人类的自主行动能力都是有限的。对家长式作风以及同意和尊重他人在医疗及其他实践中所能发挥的作用进行充分的解释,必须在一种伦理理论中展开,这种伦理理论不会强加一种关于无限自主的理想化图景,而是允许实际人类自主具有可变和部分的特征。