Informed Consent and Medical Paternalism: A Prominent Shift in the Paradigm of the Doctor-Patient relationship

AuthorJun Wei Quah
PositionUniversity of Southampton
S.S.L.R Informed Consent and Medical Paternalism Vol.6!
Informed Consent and Medical Paternalism: A
Prominent Shift in the Paradigm of the Doctor-Patient
Jun Wei Quah
University of Southampton
Autonomy, or the right to decide for oneself, is synonymous with human dignity and
are the foundational pillars of human rights. While autonomy in itself is a daedalian
notion that fleshes out into a full canvas of the human being, it is now expected and
understood that in the medical context, patients should have the basic right to make
informed choices on what he or she believes to be the best medical procedure in line
with his or her own objectives.
Yet Bolam evinces that this has not always been the case; that instead medical
paternalism has had the mastery of the Courts and indeed of the patients since
McNair J’s prominent judgment. It took the Courts half a century to finally recognize
the value of patient autonomy in Montgomery, rehabilitate the dent caused by Bolam
in medical health ethics and repudiate the suggestion that the medical profession
was above the law. This paper will examine the antithetical dichotomy between
medical paternalism and patient autonomy, concluding with English law’s
contemporary perspective on the tendentious topic of patient autonomy in the
doctor-patient relationship.
his essay will begin by defining and situating the context of medical
paternalism, followed by exploring its rise to prevalence and finally critically
analysing why it was adjudged as indecorous and unethical by society and the
judiciary towards the end of the 20th century.
The assessment of whether medical paternalism is still germane to English law today
requires traversing the history and justifications of its practice and an evaluation of
its implications from both ends of the spectrum.
1. Medical Paternalism
2.1 Medical and Philosophical Perspectives
Medical paternalism was defined as a doctor’s practice of interacting with a patient
as a father to a child and carrying out acts intended to benefit the child that may

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