ArticleJournal of medical ethics2023
The harm principle, personal identity and identity-relative paternalism.
Article in Journal of medical ethics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Mapping the Conflict Between Oral Health and Patient Autonomy in Dentistry: A Unified Qualitative-Quantitative Study.International dental journal · 2026Article
- Article
- Research Advance Directives: Ethical Implications for Persons with Alzheimer's Disease, and for the Families of Elderly Dementia Patients.The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics · 2025Article
- The conflict between oral health and patient autonomy in dentistry: a scoping review.BMC medical ethics · 2024Article
- Advance directives need full legal status in persons with dementia.Nursing ethics · 2024Article
- Patient autonomy in the era of the sustainability crisis.Medicine, health care, and philosophy · 2024Article
- Is physical restraint unethical and illegal?: a qualitative analysis of Korean written judgments.BMC nursing · 2024Article
- Ethical Considerations in Pediatric Surgery.Journal of Indian Association of Pediatric SurgeonsReview
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Authors and funding
1 author.
Funding
Abstract
Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice.In this paper, I explore Derek Parfit's arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity.Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.