| Popis: |
Because we don't have a choice when it comes to obeying a mandatory rule, the law provides us with an excuse when it makes us do something we would want to do anyway, but for what others might think. This insight is the basis for what "excuse paternalism." And for a whole class of situations in which people refrain from desirable conduct in order to appear fair - a state of affairs extremely common in patient decision-making-excuse paternalism can justify regulation. Excuse paternalism can be explained in behavioral-economic terms as the interaction between other-regarding actors (for example, trust-seeking patients), signaling costs (whatever the patient is afraid of revealing), and mandatory rules (which take the decision out of the patient's hands). This interaction can make mandatory rules beneficial because they eliminate signaling costs for other-regarding actors. Any regulation that creates such a benefit is excuse paternalistic. While any limitation on patient choice that creates this excuse-paternalism benefit will necessarily bring along costs, there will be times when the benefits outweigh the costs and a regulation will be justified. The patient reaction to mandatory second opinion programs (MSOs) is a potential example of excuse paternalism. Studies have shown patients to be very comfortable with MSOs in spite of the fact that when second opinions are not mandatory very few patients voluntarily obtain them. But if we do not mind being forced to seek a second opinion, why don't we choose to seek them on their own? While there are many contributing factors, a likely explanation is that we often want second opinions but abstain from asking our doctors for fear of hurting their feelings. On this explanation, MSO programs may be an example of excuse paternalism. |
