ABSTRACT
The resolution of ethical problems revolves around knowing when to apply which ethical principle. In medicine the principles governing treatment are non-absolutist, are clearly arranged, even though the discriminating criterion may be difficult to measure at times. Standard medical ethics is based on the following principles: autonomy; paternalism; rationality; psychiatric paternalism; and psychoanalytic consent. The principle of autonomy is clearly open to transgression by doctors who do not properly inform patients or who bring undue influence on them for various unprincipled reasons—such as financial considerations, sexual exploitation, and so on. When a patient cannot contribute to the decision, the doctor has to override the patient's right to autonomy. Allen Dyer for instance, stresses the fact that suffering may not be relieved for patients by too slavish a regard for autonomy. This is particularly common in psychiatry. The psychiatrist must, at times, adopt a position of knowing best what is good for the patient. This is an attitude of paternalism.
