Deciding for others: Paternalism, persuasion, and public health

Course Description

In this country of freedom and personal choice, it naturally follows that respect for autonomy is a key ethical principle in our health care system. But what happens when people are not competent to make their own choices – who decides for them? And perhaps a more difficult issue is what to do about people whose autonomous decisions are not in their best interest. Are decisions that result in bad outcomes truly rational? Recent high-profile cases have highlighted a shift in “public health” issues to include personal choices that threaten individual health (i.e. obesity) and the role of the government in addressing these issues (i.e. biggie soda ban). These are important issues for us to consider as we expand our scope of practice to include health and wellness, and struggle to accept the choices of others.

Course Objectives

  • Review the rationale and guidelines for informed consent
  • Outline the guidelines for surrogate decision-making
  • Compare and contrast one’s right to make bad choices vs. our duty to prevent harm
  • Explore the role of government and health care providers in protecting individuals from bad outcomes of personal choices
  • Reconsider the definitions of “public health,” “medical neglect” and abuse
  • Reflect on the special considerations when deciding for children

Continuing Education Credit

4 CEU hours for Ethics and Jurisprudence awarded by Marquette University as per WI State Statue 9.04(1) as an approved organization - courses previously approved for E&J by the WPTA. A certificate of attendance will be provided to each participant after verification of successful completion of quiz.


Tina Stoeckmann

Tina Stoeckmann, PT, DSc, MA is a Clinical Associate Professor in the Department of Physical Therapy at Marquette University. She has served on the WPTA Ethics Committee since 2000 including several years as Chair. She has also been a member of the Southeast Wisconsin Developmental Disability Ethics Committee. She received her Bachelor of Science degree in Physical Therapy from the UW – Madison in 1988, a Masters of Arts in Bioethics from the Medical College of Wisconsin in 1999, and her DSc in Neurology from Rocky Mountain University of Health Professions in 2008. Her clinical background has been primarily in neurologic rehabilitation, specializing in traumatic brain injury, and she continues to practice clinically at Froedtert Hospital on the Neurologic Rehab unit. Tina has presented to a variety of audiences at the high school, college, and professional levels on ethics topics including rehabilitation ethics, social justice, informed consent, balancing business and professional ethics, and professional boundaries, among others.