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July 20, 1984

Medical Ethics

Author Affiliations

Dartmouth Medical School
Dartmouth College Hanover, NH

JAMA. 1984;252(3):345. doi:10.1001/jama.1984.03350030019012

To the Editor.—  In their article, "Medical Ethics' Assault Upon Medical Values," Clements and Sider1 argue that "the currently dominant school in medical ethics, that of a patient autonomy-rights model based in rationalist philosophy and liberal political theory, has been used to subvert values intrinsic to medicine." The authors then attack our views as one representation of this dominant school. However, the author's characterization of our view suggests that readers of this article have been presented with an extremely distorted account of current medical ethics.They claim that we "assume the primary value of autonomy," but we never use the term autonomy at all and, in fact, are opposed to the use of that term because it has no clear ordinary meaning. Furthermore, they claim that we hold that "paternalism's negative connotation derives from the overriding value of autonomy." This is not our view at all; no statement remotely