"Self-Paternalism" : Is that Autonomy?

I would like now to move from therapeutic privilege, a lingering form of physician paternalism to another form of paternalism ("self-paternalism") called the Ulysses Contract which is used in the context of psychiatric illnesses but has also been considered in the management of narcotic drug seeking addiction. Go to the link below and read the ethical review of the subject. I look forward to your comments about whether you think this kind of doctor-patient agreement represents patient autonomy and is indeed ethical. ..Maurice.



Advance directives in psychiatric care: "Ulysses contracts are considered a form of justified self-paternalism, just like Ulysses acted paternalistically towards himself by instructing his crew to bind him to the mast of his ship before they sailed past the irresistible Sirens, and to ignore his requests for release (Lavin, 1986). Thus he was able to enjoy the beautiful singing of the Sirens without suffering the disastrous results that would normally have appeared (Elster, 1979)."