Question

Is paternalism justified when it leads to greater patient understanding of the medical issues necessary to make an informed consent?

Answer 1

Paternalism is the term used for actions we take or decisions we make for another person with the intention of benefiting that person. The word is derived from the Latin word for father and the idea is that a paternalist decision is like the decision a good father makes for his child. It is important to note that an action can only count as paternalist if it is done to benefit the other person. Actions chosen and performed to benefit the doctor, the health care system, or with mixed intentions are not paternalistic, but simply coercive.

Paternalistic decision making is not problematic if the person in question is incompetent (see latter discussion). This situation is sometimes referred to as genuine paternalism.

Paternalistic decision making is, however, problematic if the person is competent and wants to make his or her own decisions. In that case the paternalistic action overrides the autonomy of the person. Paternalistic decision making can be justified in emergency situations where there is no time to consult the patient and it can sometimes be justified in a public health context, but it is rarely, if ever justified in nonemergency interactions with individual patients.