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August 1986

The New Medical Ethics-Reply

Author Affiliations

Rochester, NY

Arch Intern Med. 1986;146(8):1629-1630. doi:10.1001/archinte.1986.00360200209036

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In Reply.  —Dr Roxe charges that we have set up a straw man by describing the new ethics as an ethics about choosing rather than an ethics about how men should lead their lives. That charge is confusing because Dr Roxe then attacks us for being authoritarian and not basing ethics on patient autonomy, on the "choice of a competent, knowledgeable adult." Dr Roxe himself substantiates our analysis of the new ethics. But we based our conceptual analysis on much more, as a careful reading of the work we cited indicates. We also refer him to Engelhardt's work, to neo-Kantian influences in the new ethics, to the President's Commissions, as ample evidence that the new ethics overvalues the principle of autonomy and undervalues naturalistic goods, accusing physicians of "weak or strong paternalism" when they seek to foster those goods. We particularly ask that Dr Roxe read our JAMA article, "Medical

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