Adlerian Theory-Birth Order, Gender, Family Values Free Essays

Adlerian’s Family Constellation Focusing on Birth Order, Gender, and Family Values Brittany Teal Bellevue University Applied Counseling Theories March 27, 2012 Abstract Diving into Adlerian’s Theory and focus on family, there are three main components to take into consideration to define how children might be defined as adults. The three factors include: birth order, gender, and family values. Birth order can make a difference in defining adult personality and behaviors. We will write a custom essay sample on Adlerian Theory-Birth Order, Gender, Family Values or any similar topic only for you Order Now Gender can play a role with its views of society and the acceptance of the up kept expectations. Family values play a role simply because it defines who the family is and makes the future generations structured and stable. Adlerian’s Family Constellation Focusing on Birth Order, Gender, and Family Values Focusing on how one’s life may be affected behaviorally and psychologically can be based off of the factors that are out of an individual’s control. When stating this sentence, it may seem confusing to know that an individual had the possibility of being â€Å"judged† or â€Å"defined† on the day they were born. With this being said, the uncontrollable, but life-shaping factors include birth order, gender, and family values. Although it is important to note that these factors will not always determine the life outcome of an individual, they will, however, create a formation of life for an individual to follow. Bringing attention to birth order first, knowing how the first born, middle, and last born child can be affected immediately can possibly define a lot about how the individual’s future could turn out. The first born child can often be described as the busy, attention receiver (Shulman Mosak 1977). On the flip side, the first born often is held to the highest expectations to uphold in the future due to the self control and respectful domineer they portray. The reason for this can be based off of the parent’s abilities to revolve their lives around engaging their child in multiple activities and organizations. This can have a lasting result on the child into adulthood in the case where they are attention seeking due to the loss of receiving it for the time they did when they were young (Carlson Sperry 2006). Next the focus moves to the middle child. The middle child seems to be the one getting loss in the mix and often found in a competition for attention (Shulman Mosak 1977). In most cases, the middle child is one who does not get to participate in as many activities as the first born, but still gets involvement in major activities and functions (Shulman Mosak 1977). The middle child can also sometimes be known as the â€Å"diplomat. † They are this simply because they get caught up in the middle between the oldest and youngest sibling. Often times it becomes natural responsibility for the middle child to be the mediator between siblings (Shulman Mosak 1977). Finally we move onto the last born child, the â€Å"baby. † The last born child can be defined as â€Å"ambitious. † An explanation to support this statement is that the youngest sibling is often times surrounded by mature adults who seem to give much attention (Shulman Mosak 1977). They also have this lifestyle due to being dependent on the older influences in their lives. When this type of behavior is allowed at a young age, the child grows into adulthood with knowing no different. On the plus side of this, the ambition the youngest child displays can often times result in success and a bright future for the youngest born (Carlson Sperry 2006). All in all, there can sometimes be more children in the mix, but results stay similar to the main three orders listed. Next the focus turns to gender effects on individuals as they enter adulthood from the Adlerian views’. When a child is born, he or she is automatically placed into the acceptable gender roles of society. When this occurs and as the child ages, he or she will decided whether or not they want to accept, reject, or adapt to the role expectations that they are given (Lindsey Christie 1997). This becomes very challenging to exactly define how an individual will be affected into adulthood due to the outside factors and influences that can take a toll on one’s life. Gender roles are something usually defined in childhood and carried into adulthood, ut as society changes and roles become more adverse, it is difficult to say how set and stone these roles will be (Carlson Sperry 2006). Overall, it is obvious one picks up gender roles on the day they are born, but it is up to the individual themselves to decide whether or not they want to maintain those roles throughout their lifestyle. Finally family values come into the picture when defining an individual as an adult. Family values ar e not only just standards up kept by family, but more or less what create a baseboard for the function of a family. There are multiple components that get taken into consideration when focusing just on family values and they are the beliefs, morals, and convictions that both the mother and father have implied to their family lifestyle (Juel 1993). With these factors being apparent at birth and throughout childhood, the individuals have choices as to whether or not they want to agree, disagree, or adopt their own family values. In most cases, children carry these values through adulthood which results in the family lifestyle getting pasted from generation to generation. To sum it all up, it takes cooperation and trust for a family to clearly define and keep family values a tradition throughout a lifetime. References Carlson, J. , Sperry, L. (2006). Adlerian therapy. Relationship Dysfunction: A Practitioner’s Guide to Comparative Treatments, 102. Juel, E. J. (1993). Non-Traditional Family Values: Providing Quasi-Marital Rights to Same-Sex Couples. BC Third World LJ, 13, 317. Lindsey, L. L. , ; Christie, S. (1997). Gender roles. Prentice Hall. Shulman, B. H. , ; Mosak, H. H. (1977). Birth order and ordinal position: Two Adlerian views. Journal of Individual Psychology, 33(1), 114-121. How to cite Adlerian Theory-Birth Order, Gender, Family Values, Essay examples Adlerian Theory-Birth Order, Gender, Family Values Free Essays Adlerian’s Family Constellation Focusing on Birth Order, Gender, and Family Values Brittany Teal Bellevue University Applied Counseling Theories March 27, 2012 Abstract Diving into Adlerian’s Theory and focus on family, there are three main components to take into consideration to define how children might be defined as adults. The three factors include: birth order, gender, and family values. Birth order can make a difference in defining adult personality and behaviors. We will write a custom essay sample on Adlerian Theory-Birth Order, Gender, Family Values or any similar topic only for you Order Now Gender can play a role with its views of society and the acceptance of the up kept expectations. Family values play a role simply because it defines who the family is and makes the future generations structured and stable. Adlerian’s Family Constellation Focusing on Birth Order, Gender, and Family Values Focusing on how one’s life may be affected behaviorally and psychologically can be based off of the factors that are out of an individual’s control. When stating this sentence, it may seem confusing to know that an individual had the possibility of being â€Å"judged† or â€Å"defined† on the day they were born. With this being said, the uncontrollable, but life-shaping factors include birth order, gender, and family values. Although it is important to note that these factors will not always determine the life outcome of an individual, they will, however, create a formation of life for an individual to follow. Bringing attention to birth order first, knowing how the first born, middle, and last born child can be affected immediately can possibly define a lot about how the individual’s future could turn out. The first born child can often be described as the busy, attention receiver (Shulman Mosak 1977). On the flip side, the first born often is held to the highest expectations to uphold in the future due to the self control and respectful domineer they portray. The reason for this can be based off of the parent’s abilities to revolve their lives around engaging their child in multiple activities and organizations. This can have a lasting result on the child into adulthood in the case where they are attention seeking due to the loss of receiving it for the time they did when they were young (Carlson Sperry 2006). Next the focus moves to the middle child. The middle child seems to be the one getting loss in the mix and often found in a competition for attention (Shulman Mosak 1977). In most cases, the middle child is one who does not get to participate in as many activities as the first born, but still gets involvement in major activities and functions (Shulman Mosak 1977). The middle child can also sometimes be known as the â€Å"diplomat. † They are this simply because they get caught up in the middle between the oldest and youngest sibling. Often times it becomes natural responsibility for the middle child to be the mediator between siblings (Shulman Mosak 1977). Finally we move onto the last born child, the â€Å"baby. † The last born child can be defined as â€Å"ambitious. † An explanation to support this statement is that the youngest sibling is often times surrounded by mature adults who seem to give much attention (Shulman Mosak 1977). They also have this lifestyle due to being dependent on the older influences in their lives. When this type of behavior is allowed at a young age, the child grows into adulthood with knowing no different. On the plus side of this, the ambition the youngest child displays can often times result in success and a bright future for the youngest born (Carlson Sperry 2006). All in all, there can sometimes be more children in the mix, but results stay similar to the main three orders listed. Next the focus turns to gender effects on individuals as they enter adulthood from the Adlerian views’. When a child is born, he or she is automatically placed into the acceptable gender roles of society. When this occurs and as the child ages, he or she will decided whether or not they want to accept, reject, or adapt to the role expectations that they are given (Lindsey Christie 1997). This becomes very challenging to exactly define how an individual will be affected into adulthood due to the outside factors and influences that can take a toll on one’s life. Gender roles are something usually defined in childhood and carried into adulthood, ut as society changes and roles become more adverse, it is difficult to say how set and stone these roles will be (Carlson Sperry 2006). Overall, it is obvious one picks up gender roles on the day they are born, but it is up to the individual themselves to decide whether or not they want to maintain those roles throughout their lifestyle. Finally family values come into the picture when defining an individual as an adult. Family values ar e not only just standards up kept by family, but more or less what create a baseboard for the function of a family. There are multiple components that get taken into consideration when focusing just on family values and they are the beliefs, morals, and convictions that both the mother and father have implied to their family lifestyle (Juel 1993). With these factors being apparent at birth and throughout childhood, the individuals have choices as to whether or not they want to agree, disagree, or adopt their own family values. In most cases, children carry these values through adulthood which results in the family lifestyle getting pasted from generation to generation. To sum it all up, it takes cooperation and trust for a family to clearly define and keep family values a tradition throughout a lifetime. References Carlson, J. , Sperry, L. (2006). Adlerian therapy. Relationship Dysfunction: A Practitioner’s Guide to Comparative Treatments, 102. Juel, E. J. (1993). Non-Traditional Family Values: Providing Quasi-Marital Rights to Same-Sex Couples. BC Third World LJ, 13, 317. Lindsey, L. L. , ; Christie, S. (1997). Gender roles. Prentice Hall. Shulman, B. H. , ; Mosak, H. H. (1977). Birth order and ordinal position: Two Adlerian views. Journal of Individual Psychology, 33(1), 114-121. How to cite Adlerian Theory-Birth Order, Gender, Family Values, Essays

TV Violence free essay sample

A look at the complexities involved in television violence and how it effects childrens lives. This literature review is all about television violence and the effects on youth. The author attempts to examine whether television consumption cause children to imitate behavior. The author includes an examination of how parent involvement interacts. This research includes statistics as proof variables. From the paper: Television is a part of life. Virtually every household has a television set and many homes have two or three (Ledingham, 1993). Needless to say, television plays an enormous role in the lives of many American families and the magnitude of its influence on people is considerable also. This is especially true where children are involved. According to Liebert Sprafkin (1988), television viewing time rises from about 2.5 hours per day at the age of five to about 4 hours a day at the age of 12. Ledingham goes on to say that television is used frequently by parents as a babysitter or distraction device (1993). We will write a custom essay sample on TV Violence or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page

Tle Assignment ! Jermieanneliyaniieh free essay sample

Microsoft Publisher is an entry-level desktop publishing application from Microsoft, differing from Microsoft Word in that the emphasis is placed on page layout and design rather than text composition and proofing. Define the Following Quick access Toolbar *The Quick Access Toolbar (CAT) is a small, customizable toolbar that exposes a set of Commands that are specified by the application or selected by the user. Page Navigation *In essence, a Tapestry application is a number of related pages, working together. To some degree, each page is like an application unto itself. Ribbon *Ribbons are the modern way to help users find, understand, and use commands efficiently and directly?with a minimum number of clicks, with less need to resort to trial-and-error, and without having to refer to Help. Viewing Tools *Use the tools on the Viewing tools toolbar when you are viewing an Information Item/Document in the Centric Project Viewer or when you are viewing a markup for an Information Item/Document. We will write a custom essay sample on Tle Assignment ! Jermieanneliyaniieh or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Rulers A ruler, sometimes called a rule or line gauge, is an instrument used in geometry, technical drawing, printing as well as engineering and building to measure distances or to rule straight lines. The ruler is a straightedge which may also contain calibrated lines to measure distances Baseline *A baseline is a line that is a base for measurement or for construction; see datum(calculations or comparisons) or point of reference (engineering or science). Boundaries *Boundary (plural: boundaries) may refer to any meaning below, also to border. Guides *A guide is a person who leads anyone through unknown or unmapped country. This includes a guide of the real world (such as someone who conducts travelers and tourists through a place Of interest), as well as a person who leads someone to more abstract places (such as to knowledge or wisdom). Mage Guide Customizable Guide Task pane *Microsoft Office feature found in Microsoft Office 2002 (XP), Office 2003, and later versions that enables users to have quick access to common features, information, and commands. By default the Microsoft task pane opens on the right hand side of the window. Users who need access to the task pane and are running a compatible version of Microsoft Office can get to the task pane by using the keyboard shortcut CTR + Fl or by clicking View and then Task Pane. Backstage View *The Ribbon contains the set of commands for working in a document, while the Microsoft Office Backstage view is the set of commands you use to do things to a document. Tale Assignment ! Jermieanneliyaniieh ! By Jerkily

The Principle of Beneficence vs Patient Essays

The Principle of Beneficence vs Patient Essays The Principle of Beneficence vs Patient Paper The Principle of Beneficence vs Patient Paper ABSTRACT On the motion that â€Å"medical paternalism serves the patient best†, this essay reviews current arguments on medical paternalism vs. patient autonomy. Citing medico-ethical texts and journals and selected real-life applications like electroconvulsive therapy (ECT) and the advanced medical directive (AMD), the essay argues that medical paternalism cannot serve the patient best insofar as current debates limit themselves to â€Å"who† wields the decision-making power. Such debates side-step â€Å"what† the patient’s best interests are. The essay further argues through the case of Traditional Chinese Medicine (TCM), and acupuncture in particular, that the current dominant Western school of thought excludes other forms of â€Å"alternative† treatment through medical paternalism. Singapore Med J 2002 Vol 43(3):148-151 N H S S Tan Second-year mass communication student at Ngee Ann Polytechnic Correspondence to: Noel Hidalgo Tan Suwi Siang Email: [emailprotected] pacific. net. sg Although probably not written by Hippocrates (c. 460 – c. 477 BC) himself, the Hippocratic Oath is one of the oldest, most binding code of conduct today. The oath expresses the aspirations of the physician, and sets the ethical precedent by spelling out the physician’s responsibilities to the patient and the medical profession. Today, the Hippocratic Oath has been adopted and adapted world-wide; all physicians take the oath in some form or another. In Singapore, the doctor who undertakes the Singapore Medical Council’s Physician’s Pledge promises to â€Å"make the health of my patient my first consideration† and â€Å"maintain due respect for human life† (pars. 4, 9). The primary concept behind the oath is the principle of beneficence, which is operationalised in the original oath as the resolve to serve â€Å"for the benefit of the sick according to (the physician’s) ability and judgement† (cited in Mappes DeGrazia, 1996; p. 59). The principle of beneficence, indeed the over-emphasis of it, also led to medical paternalism or the physician’s prerogative to act on his or her best judgement for the patient. R S Downie observed, â€Å"The pathology of beneficence is paternalism, or the tendency to decide for individuals what they ought to decide form themselves† (cited in 1996; p.5). More often than not, medical paternalism tends to focus more on the patient’s care and outcomes rather than the patient’s needs and rights. In recent years, medical paternalism has come under fire through the concept of patient autonomy, or the patient’s right to choose and refuse treatment. While the debate between autonomy and paternalism still remains unresolved, paternalists argue that â€Å"maximum patient benefit† can be achieved only when the doctor makes the final medical decision (Weiss, 1985; p. 184). The pro-autonomy stance maintains that â€Å"benevolent paternalism is considered inappropriate in a modern world where the standard for the client-professional relationship is more like a meeting between equals than like a father-child relationship† (Tuckett, Boulton, Olson Williams, cited in Nessa Malterud, 1998; p. 394). This essay argues that medical paternalism cannot serve the patient best insofar as current debates sidestep the principle of beneficence in favour of decision-making power and medical paternalism under the current dominant Western school of thought excludes other forms of treatment. Current debate surrounding paternalism has always been centred on the issues of autonomy and paternalism and reduced further into a power struggle between the doctor and patient. This polarisation of the decision-making power has distracted the medico-philosophical debate. Today’s traditional medical values like â€Å"pain is bad† and longer life is more desirable than a shorter one† are increasingly challenged. Still, do patient and physician both share common understanding of what is best for the patient? Paternalists would claim that physicians have a â€Å"medical tradition to serve the patient’s well-being†, with the prerogative to preserve life and thus have the patient’s best interests at heart (Mappes and DeGrazia, 1996; p. 52). Singapore Med J 2002 Vol 43(3) : 149 Far from paternalism understood as a dogmatic decision made by the physician, James Childress in his book â€Å"Who Shall Decide? † further expounds paternalism into multi-faceted dimensions. Pure paternalism intervenes on account of the welfare of a person, while impure paternalism intervenes because more than one person’s welfare is at stake. Restricted paternalism curbs a patient’s inherent tendencies and extended paternalism encompasses minimising risk in situations through restrictions. Positive paternalism promotes the patient’s good and negative paternalism seeks to prevent an existing harm. Soft paternalism appeals to the patient’s values and hard paternalism applies another’s value over the patient. Direct paternalism benefits the person who has been restricted and indirect paternalism benefits a person other than the one restricted. Whatever the case may be, the guiding principle of modern paternalism,† says Gary Weiss, â€Å"remains that the physician decides what is best for the patient and tries to follow that course of action† (1985; p. 184). That the physician determines ‘what is best’ is questionable. The medical profession’s back-to-basics Hippocratic prerogative is prone to strong medical paternalism, implying that the patient does not want or know his or her own personal good and conversely implying that the patient is to be given no choice other than the physician’s. Consequently, there is immense potential for abuse by giving the physician the final say. Actively, a paternalist physician may declare a person mentally unsound – and thus incompetent – because the patient refuses treatment. Passively, the physician can confound informed consent and obfuscate treatment alternatives. In some cases information can be misrepresented entirely, as John Breeding (2000) argues in his report on electroshock, or electroconvulsive therapy (ECT). He states that patients who sign up for ECT have no real choice â€Å"because electroshock psychiatrists deny or minimise its harmful effects† (p. 65). Breeding reports a â€Å"lack of efficacy† in the ECT procedure with â€Å"no lasting beneficial effects of ECT† and the â€Å"(physical) and mental debilitation for people who undergo this procedure†. There are, however, some justifications for paternalistic intervention, which generally entails situations where intervention outweighs the harm from non-intervention. The weak paternalistic approach is especially warranted to  prevent a person from posing a danger to oneself, or when the patient in question is a minor or suffers from impaired judgement due to illness. For example, in Dr Y M Lai and Dr S M Ko’s paper on the assessment of suicide risk, a paternalistic stand is seen where â€Å"accurate diagnosis and careful management of the acute psychiatric illness could significantly alter the suicide risk† (1999). Still, physicians might know for themselves what is best for the situation as they perceive it, but that knowledge does not necessarily translate to what may be best for the patient. Ruddick adds, â€Å"(Current) hospital specialists, it is said, rarely know their patient (or themselves) well enough to make this assumption without serious risk of ignorant arrogance† (1998; par. 5). Therefore while much debate has gone on about medical paternalism and patient autonomy, the definition on what serves the patient best remains unanswered, but the notion of medical paternalism continue to be redefined. On the other side of the argument, proponents of patient autonomy hold that the final say lies with the patient. â€Å"It is the patient’s life or health which is at stake, not the physician’s so it must be the patient, not the physician, who must be allowed to decide whether the game is worth the candle† (Matthews, 1986; p. 134). The notion of patient autonomy largely derives from philosophies of Immanuel Kant and John Stuart Mill, who, through different postulations, arrived at the same conclusion – that freedom of choice is paramount. Autonomy â€Å"asserts a right to noninterference and a correlative obligation not to restrain choice† (Pollard, 1993, p.797). Retroactively, the emergence of the idea of patient autonomy has slowly eroded the normative model of medical paternalism. Dr K O Lee and Dr T C Quah (1997) observe â€Å"(the) commercialisation and cost of medicine, the loss of absolutes in morality, indeed the dominance of pluralism such that ethical issues are discussed without firm foundations, these have all led to fewer patients (or their relatives) saying ‘Doctor, you do what you think is best Sir’. † (par. 3). Unlike the paternalist view that deems illness as an impediment to autonomy, the patient autonomy model, as Cassel asserts, sees the patient â€Å"simply as a well person with a disease, rather than as qualitatively different, not only physically but also socially, emotionally and even cognitively† (1978, p. 1675). Thus, proponents of patient autonomy rationalise, â€Å"Who better to determine what’s best for the patient than the patient themselves? † This shift in thinking has increasingly made patient autonomy the desirable standard for medical relationships. The advance medical directive (AMD), legislated in 1991 in America and 1996 in Singapore, reflects such a shift, albeit legal, towards providing power to patient choice. The AMD is a document 150 : 2002 Vol 43(3) Singapore Med J that â€Å"is basically designed to provide autonomy to patients to determine in advance their wish to die naturally and with dignity when death is imminent and when they lose their capacity to decide or communicate† (Agasthian, 1997; par. 1). There is, however, little consensus as to what autonomy entails. According to Thomas Shannon, autonomy has two elements: â€Å"First, there is the capacity to deliberate about a plan of action. One must be capable of examining alternatives and distinguishing between them. Second, one must have the capacity to put one’s plan into action. Autonomy includes the ability to actualise or carry out what one has decided† (1997; p. 24). Nessa and Maltrud (1998) say â€Å"[within] the biomedical tradition, patient autonomy implies a right to set limits for medical intervention† (p. 397). Pollard (1993) understands autonomy as â€Å"a person’s cognitive, psychological and emotional abilities to make rational decisions† (p. 797). With each definition, the interwoven faculties of personal liberty, voluntariness, being informed, and competence to engage in a plan of action appear. Philosophically, these faculties are subject, and subject autonomy, to varying degrees. This subjectivity begs the question, â€Å"What construes as a mentally competent patient? † How much would an illness impede a patient’s autonomy? How much autonomy does a person have with respect to his or her obligations to the community? Can a person ever have true and full access to information in order to make an informed decision? Criticism towards advocates of patient autonomy also point out that patients sometimes â€Å"choose immediate gratification over long-term benefits† (Weiss, 1985; p. 186). An exercise of autonomy may fulfil the patient’s expressed desire but not necessarily translate to serving the patient best, if at all. Even with the patient autonomy model, then, the question as to what serves the patient best goes unanswered and gives way to what the patient wants. To the extent that medical paternalism is discussed in relation with patient autonomy, current debates talk only about ‘who’ should determine the best interests of the patient but not ‘what’ the best interests of the patient should be. Thus, the principle of beneficence cannot be attained in both the minds of the physician or the patient. Where current debate about paternalism sidesteps beneficence as the motivation for paternalism, medical paternalism itself sidesteps questions of its own validity through the established dominant Western thinking. Eric Matthews argues that â€Å"paternalism rests on the claim that the goods which medicine pursues are determined by the medical profession rather than the patients who make uses of their service† (p. 135). In this argument, medical paternalism also determines the very medicine the medical profession uses and leaves the patient with little or no choice for ‘alternatives’. â€Å"Whether they agreed or not, physicians needed to become more knowledgeable about alternative regimes†, reports Eugene Taylor on the use of alternative therapies (2000; p. 33). Only in recent times, with the proliferation of information spurred by the advent of the Internet age has given an indication about how little the dominant Western medical school of thought knows about other existing and so-called ‘alternative’ healing therapies and are beginning to react. In America, the National Center for Complementary and Alternative Medicines’ (NCCAM) budget â€Å"exploded from $2 million in 1993 to $50 million in 1999† (Waltman, 2000; p. 39). Singapore is now looking into developing traditional Chinese medicine (TCM) â€Å"research and education to the tune of US$100 million† (Kao, 2001; p.3). Going with this positive trend, Dr. P H Feng (2000) surmised that someday patients will have â€Å"unlimited access to medical information† (p. 524). Despite the growing acceptance of alternative medical therapies, the Western medical profession also exacts paternalistic standards on alternative medicines. Take the example of TCM, of which studies in China have revived over the past few decades. A Singaporean report on TCM in 1995 reviewed â€Å"the standards of training and practice of TCM in Singapore to ensure a higher quality of TCM practice  (and) to safeguard patient interest and safety† (Traditional Chinese Medicine, 1995; par. 2, 3). Yet to demand that ‘alternative’ therapies undergo review under Western medical criteria is as laughable as it is paternalistic. Says Eugene Taylor, â€Å"Can we actually understand acupuncture without reading the Five Confucian Classics or The Yellow Emperor’s Classic on Traditional Chinese Medicine? Western practitioners would say we don’t need them if we have the scientific evidence; Chinese practitioners would consider this the answer of an uncultivated dog-faced barbarian† (p. 33). Ironically, while Western scientific method emerged from Cartesian thought in the 17 th century, Jeffrey Singer notes that the Chinese had â€Å"documented theories about circulation, pulse, and the heart over 4,000 years before European medicine had any concept about them† (2000; par. 3). Other regimes like homeopathy and aromatherapy have been in existence for centuries but are now deemed â€Å"alternative†, pseudonyms for â€Å"nonWestern†. This is paternalism at its worst because Singapore Med J 2002 Vol 43(3) : 151 so-called â€Å"alternative† therapies do not hold water, or are even oppressed by, a dominant Western medical standard. Wrote Angela Coulter, â€Å"Assumptions that doctor (or nurse) knows best, making decisions on behalf of patients without involving them and feeling threatened when patients have access to alternative sources of medical information these signs of paternalism should have no place in modern health care† (1999; p. 719). The principle of beneficence is furthermore stymied through this kind of medical paternalism – how can the medical profession presume to serve the patient best when it fails to acknowledge other therapies that work? The medical profession must begin to re-look itself. Thus far, solutions towards resolving the paternalism problem deal exclusively with advocating either paternalism, autonomy, or middle-road, shared decision patient-physician relationship models such as the one proposed by Elywn, Edwards, Gwyn and Grol. They propose â€Å"sharing the uncertainties about the outcomes of medical processes and exposing the fact that data are often unavailable or not known† (1999; p. 753). Again, proposed shared-decision solutions deal with co-responsibility of medical decisions, but the solutions do not determine the decision itself, and whether the decision serves the patient best. Indeed, a quantitative solution may be near impossible, such is the dynamics of any ethical issue. Medical paternalism, however, must be deconstructed as an issue by both the medical profession and the patient. To approach a resolution through the eyes of the medical profession only serves to perpetuate medical paternalism, albeit in another form, which would not serve the patient. Surmises R S Downie, â€Å"The antidote to paternalism, or an inappropriate excessive expression of beneficence is a sense of justice and honesty† (1996; p. 5). Medical practitioners then must also start recognising their own limitations as a healthcare provider and the limitations of knowledge in their own profession. It is a certain humility reflected in a physician’s comment during a study by Sullivan, Menapace and White (2001), â€Å"I’m not the God of this patient, just a technician with an education†. REFERENCES 1. Agasthian T. Advance directive – A surgical viewpoint. Singapore Medical Journal (Online serial), 1997; 38(4). Retrieved June 23, 2001 from the World Wide Web: sma. org. sg/smj/3804/articles/ 3804e2. htm 2. Breeding J. Electroshock and informed consent. The Journal of Humanistic Psychology, 2000; 40:65-79. 3. Cassel E. Therapeutic relationship: contemporary medical perspective. In W. Reich (Ed), Encyclopaedia of Ethics (p. 1675). New York: Macmillan. 1978. 4. Coulter A. Paternalism or partnership? British Medical Journal, 1999; 319:719-20. 5. Downie RS. Professional ethics and business ethics. In S. A. M. McLean (Ed. ), Contemporary Issues in Law, Medicine and Ethics. Vermont: Dartmouth. 1996. 6. Elwyn G, Edwards A, Gwyn R and Grol R. Towards a feasible model for shared decision making: focus group study with general practice registrars. British Medical Journal 1999; 319:753-6. 7. Feng PH. Medicine in the digital era – Opportunities and challenges. Singapore Medical Journal, 2000; 41:522-4. 8. Kao C. $175m plan for Chinese medicine. The Straits Times, 9 September 2001; p. 3. 9. Lai YM and Ko SM. What you need to know – Assessment of suicide risk. Singapore Medical Journal (Online serial), 1999; 40(5). Retrieved June 23, 2001 from the World Wide Web: http:// www. sma. org. sg/smj/4005/articles/4005me2. html 10. Lee KO and Quah TC. Living, dying, death and advance directives. Singapore Medical Journal (Online serial), 1997; 38(4). Retrieved June 23, 2001 from the World Wide Web: sma. org. sg/smj/3804/ articles/3804e1. htm 11. Mappes TA and DeGrazia D. Biomedical ethics (4th ed. ). New York: McGraw-Hill. 1996. 12. Matthews E. Can paternalism be modernised? Journal of Medical Ethics 1986; 12:133-5. 13. Nessa J and Malterud K. Tell me what’s wrong with me: a discourse analysis approach to the concept of patient autonomy. Journal of Medical Ethics, 1998; 24:394-400. 14. Pollard BJ. Autonomy and paternalism in medicine. The Medical Journal of Australia, 1993; 159:797-802. 15. Ruddick W. Medical Ethics (Online), 1998. Retrieved June 23, 2001 from the World Wide Web: nyu. edu/gsas/dept/philo/faculty/ ruddick/papers/medethics. html 16. Singer JA. 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