Physicians as choice architects: Paternalism and respect for autonomy

Abstract

The doctor-patient relationship differs significantly from other social interactions, and in the last years studies on this subject have grown significantly. The concept of autonomy now also encompasses patients, with notable expansion of their sphere of participation and influence in decision-making in treatments and clinical procedures, mitigating that overly paternalistic role of the physician. But this change poses a serious question: what are the limits of this autonomy? This article believes in the solution of libertarian paternalism, an idea proposed by Richard Thaler and Cass Sunstein, in which the doctor acts as a choice architect for the patient. Based on the hypothetico-deductive method, this study verifies the possibility of adapting libertarian paternalism to current medical practices, mainly in hard cases, establishing the scope and limits of patient autonomy.