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Nursing Ethics
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Patient Autonomy and Medical Paternity: can nurses help doctors to listen to patients?

Sarah Breier-Mackie

breiermackie{at}aol.com

Nurses are increasingly faced with situations in practice regarding the prolongation of life and withdrawal of treatment. They play a central role in the care of dying people, yet they may find themselves disempowered by medical paternalism or ill-equipped in the decision-making process in end-of-life situations. This article is concerned with the ethical relationships between patient autonomy and medical paternalism in end-of-life care for an advanced cancer patient. The nurse’s role as the patient’s advocate is explored, as are the differences between nursing and medicine when confronted with the notion of patient autonomy. The impetus for this discussion stems from a clinical encounter described in the following scenario.

Key Words: autonomy • end-of-life care • medical futility • paternity

Nursing Ethics, Vol. 8, No. 6, 510-521 (2001)
DOI: 10.1177/096973300100800605
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H.-M. Hilden and M.-L. Honkasalo
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D. Hyland
An Exploration of the Relationship Between Patient Autonomy and Patient Advocacy: implications for nursing practice
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