Title: Autonomy and paternalism at the end of life for elderly patients


Populations across the world are aging. Concomitantly, the patterns of death and dying are changing as a result with death most frequently preceded now by a prolonged period, often of many years, marked by physical, mental and social decline accompanied by increasing frailty and dependence on others. The end of life phase is marked by a heightened risk of conflict between the autonomy of individuals and paternalism which, although almost always well intentioned, can inadvertently adversely impact on the autonomy of elderly patients. This Thesis critically examines the complex relationships between autonomy and paternalism for elderly patients approaching the end of life. It examines what is currently known about elderly patients’ views on autonomy and how they may wish to exert it at the end of life and how the state as the main provider of care and protector and promotor of autonomy fulfils these obligations.This thesis demonstrates that elderly patients view the importance of autonomy as an enabler to make moral choices. Moreover, that greater attention needs to be focussed on the risks of harm from well-intentioned policy initiatives.The Thesis draws on literature and analytical approaches from bioethics, philosophy, sociology, psychology and public health.The Thesis concludes with words of caution and recommendations for all sectors of society on how to achieve better care while respecting the autonomy of elderly patients.

Place of publishing:


Level of degree:

2 - studia doktoranckie

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Nauk o Zdrowiu.


Jan Hartman

Date issued:






Call number:


Access rights:


Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Object collections:

Last modified:

Oct 7, 2020

In our library since:

Oct 7, 2020

Number of object content hits:


All available object's versions:


Show description in RDF format:


Show description in OAI-PMH format:


Edition name Date
ZB-131395 Oct 7, 2020


Citation style:

This page uses 'cookies'. More information