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Medical maternalism: beyond paternalism and antipaternalism
  1. Laura Specker Sullivan1,2
  1. 1Center for Sensorimotor Neural Engineering, University of Washington, Seattle, Washington, USA
  2. 2National Core for Neuroethics, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Laura Specker Sullivan, Center for Sensorimotor Neural Engineering, University of Washington, Seattle, 1414 NE 42nd St, Suite 204, Seattle, WA 98105-6271, USA; specker{at}


This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians’ non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to decide for another person based on a reasonable understanding of that person's own preferences. The concept of maternalism allows for a more thorough assessment of the moral justification of these types of actions. I conclude that it is possible, at least in principle, to justify Japanese physicians’ non-disclosures, and that this justification must be based on an understanding of these actions as maternalistic.

  • Paternalism
  • Decision-making
  • Informed Consent
  • Truth Disclosure
  • Cultural Pluralism

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