Abstract

KIE: The emphasis on patient autonomy in medical decision making which emerged in the 1970s is described as a reaction against the paternalistic viewpoint which reigned unchallenged until then. While strongly agreeing that respect for the patient's autonomy takes moral precedence over benefiting the patient against his autonomous will, Veatch maintains that the implications of this principle of autonomy are limited because it does not encompass a social ethic for medicine. He rejects the use of cost-benefit analysis for achieving a social ethic, illustrating the shortcomings of this approach with a case study involving mass screening. He opts instead for an ethic of justice which maximizes benefits within the constraints of the uniqueness of individuals as equals in their claim on social resources.