Medical paternalism and patient self-determination.

In response to the common belief that paternalism directed toward a competent patient necessarily transgresses the patient's right of self-determination and is therefore morally suspect, the authors argue that such a general view fails to appreciate the complexity of the patient/physician relationship as it is manifested in various clinical settings. It is the authors' contention that some strongly paternalistic acts may fail to violate the patient's right of autonomy, that other such acts may actually be a function of respect for patient autonomy, and that others may only suspend or momentarily infringe upon patient autonomy. They conclude that if these instances of paternalism differ from the classical examples of strong paternalism, then so also should the moral appraisal.