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J Adolesc Health Care. 1989 Nov;10(6):449-53.

Justified paternalism in adolescent health care. Cases of anorexia nervosa and substance abuse.

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  • George Washington University School of Medicine and Health Sciences, Department of Adolescent and Young Adult Medicine, Children's National Medical Center, Washington, D.C. 20010.


This essay on the limits of adolescent autonomy espouses justified paternalism in adolescent medicine as a 1980s alternative to the "antipaternalistic" rights position of the 1970s. Thus, it proposes that the harm principle be a basis for justified limitations of liberty. In turn, justified paternalism should be both testable and severely limited because by definition it always involves treating someone in a way that violates a moral rule (e.g., coercive deprivation of freedom, invasion of privacy). Therefore, paternalism can only be justified when the evil prevented from occurring to the person is greater than the wrong caused by the violation of the moral rule and, more importantly, if it can be universally justified under relevantly similar circumstances always to treat persons in this way.

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