Patient Preference Predictors and Paternalism in Military Medicine

In Daniel Messelken & David Winkler (eds.), Health Care in Contexts of Risk, Uncertainty, and Hybridity. Springer. pp. 101-114 (2021)
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Abstract

Patient preference predictors take us from known demographic descriptors to unknown facts about patients’ preferences over treatment options. However, the use of PPPs to make treatment decisions on behalf of incapacitated patients faces an apparent normative problem: their use in certain contexts appears to involve treating patients paternalistically. In this paper, I consider whether PPPs can find a home in the context of military medicine. On the assumptions that military organizations sometimes permissibly treat their members paternalistically, I identify the specific circumstances in which PPPs can play a role in making treatment decisions on behalf of patients. I show that these circumstances are not only the natural home of PPPs, PPPs – or something very much like them – are precisely the sort of device required for it to be permissible to paternalistically override a patient’s expressed preferences.

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Nathaniel Sharadin
University of Hong Kong

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