Summary: Interference with the FREEDOM or PERSONAL AUTONOMY of another person, with justifications referring to the promotion of the person's good or the prevention of harm to the person. (from Cambridge Dictionary of Philosophy, 1995); more generally, not allowing a person to make decisions on his or her own behalf.

Top Publications

  1. Gostin L, Gostin K. A broader liberty: J.S. Mill, paternalism and the public's health. Public Health. 2009;123:214-21 pubmed publisher
    ..This article directly and forcefully questions the Millian principle, making the case for hard paternalism. When seen from a population-based perspective that counts the number of lives saved, paternalism becomes a ..
  2. Ploug T, Holm S, Brodersen J. To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism. J Epidemiol Community Health. 2012;66:1193-6 pubmed publisher
    Nudging--and the underlying idea 'libertarian paternalism'--to an increasing degree influences policy thinking in the healthcare sector...
  3. Jefford M, Savulescu J, Thomson J, Schofield P, Mileshkin L, Agalianos E, et al. Medical paternalism and expensive unsubsidised drugs. BMJ. 2005;331:1075-7 pubmed
  4. Gostin L. "Police" powers and public health paternalism: HIV and diabetes surveillance. Hastings Cent Rep. 2007;37:9-10 pubmed
  5. Makoul G, Clayman M. An integrative model of shared decision making in medical encounters. Patient Educ Couns. 2006;60:301-12 pubmed
    ..The integrative definition of SDM is intended to provide a useful foundation for describing and operationalizing SDM in further research. ..
  6. Lynoe N, Juth N, Helgesson G. How to reveal disguised paternalism. Med Health Care Philos. 2010;13:59-65 pubmed publisher
    ..There is considerable risk that they will disguise their paternalism by giving 'socially correct answers'...
  7. Taylor K. Paternalism, participation and partnership - the evolution of patient centeredness in the consultation. Patient Educ Couns. 2009;74:150-5 pubmed publisher
    ..As such, healthcare professionals may need to advocate for the continuing role of the patient-centered consultation. ..
  8. Sandman L, Munthe C. Shared decision making, paternalism and patient choice. Health Care Anal. 2010;18:60-84 pubmed publisher far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g...
  9. Christensen M, Hewitt Taylor J. Empowerment in nursing: paternalism or maternalism?. Br J Nurs. 2006;15:695-9 pubmed
    ..Although empowerment is often viewed on a one-to-one level between professionals and patients, for true patient empowerment to occur, issues of power and control must also be addressed at a national and political level. ..

More Information


  1. Buchanan D. Autonomy, paternalism, and justice: ethical priorities in public health. Am J Public Health. 2008;98:15-21 pubmed
    ..Efforts focused on specifying the conditions that warrant paternalism, however, are largely misplaced...
  2. Ommen O, Janssen C, Neugebauer E, Bouillon B, Rehm K, Rangger C, et al. Trust, social support and patient type--associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients. Patient Educ Couns. 2008;73:196-204 pubmed publisher
    ..quot;Patient type" measures patients preferences in regard to paternalism of physician, clarification of medical facts and participation in treatment...
  3. Sine D. The architecture of madness and the good of paternalism. Psychiatr Serv. 2008;59:1060-2 pubmed publisher
    ..The author examines the ethical basis for decisions about the design of psychiatric hospitals--architectural paternalism. The ethic of paternalism in the design of asylums and in contemporary thinking about psychiatric hospital ..
  4. Rodriguez Osorio C, Dominguez Cherit G. Medical decision making: paternalism versus patient-centered (autonomous) care. Curr Opin Crit Care. 2008;14:708-13 pubmed publisher
    ..Clinicians should then ensure proper information is provided for informed decision making and minimize factors that could have potential adverse effect. ..
  5. Gavaghan C. "You can't handle the truth"; medical paternalism and prenatal alcohol use. J Med Ethics. 2009;35:300-3 pubmed publisher
  6. Zomorodi M, Foley B. The nature of advocacy vs. paternalism in nursing: clarifying the 'thin line'. J Adv Nurs. 2009;65:1746-52 pubmed publisher
    This paper is an exploration of the concepts of advocacy and paternalism in nursing and discusses the thin line between the two...
  7. McCullough L. Was bioethics founded on historical and conceptual mistakes about medical paternalism?. Bioethics. 2011;25:66-74 pubmed publisher
    Bioethics has a founding story in which medical paternalism, the interference with the autonomy of patients for their own clinical benefit, was an accepted ethical norm in the history of Western medical ethics and was widespread in ..
  8. Ravinetto R, Buve A, Halidou T, Lutumba P, Talisuna A, Juffrie M, et al. Double ethical review of North-South collaborative clinical research: hidden paternalism or real partnership?. Trop Med Int Health. 2011;16:527-30 pubmed publisher
    ..Proactive communication would help to build collaborative partnership among ethical bodies, promoting common practices and resolving conflicting opinions. ..
  9. Vyshka G, Kruja J. Inapplicability of advance directives in a paternalistic setting: the case of a post-communist health system. BMC Med Ethics. 2011;12:12 pubmed publisher
    ..Tricks to avoid institutional treatment under desperate conditions are used, aiming to provide legal coverage for medical teams and relatives that in extreme situations comply with the advice of withholding senseless treatment. ..
  10. Nair Collins M. Brain death, paternalism, and the language of "death". Kennedy Inst Ethics J. 2013;23:53-104 pubmed
    ..If the paternalism is not justified, then either the language used to describe organ transplantation must change radically, or it ..
  11. Chin J. Doctor-patient relationship: from medical paternalism to enhanced autonomy. Singapore Med J. 2002;43:152-5 pubmed
    ..With the radical rise in emphasis on individual control and freedom, medical paternalism no longer receives unquestioned acceptance by society as the dominant mode for decision-making in health care...
  12. Falkum E, Førde R. Paternalism, patient autonomy, and moral deliberation in the physician-patient relationship. Attitudes among Norwegian physicians. Soc Sci Med. 2001;52:239-48 pubmed
    ..Three moderately correlated theoretical dimensions were identified in a principal component analysis: paternalism, patient autonomy, and moral deliberation...
  13. Høyer G, Kjellin L, Engberg M, Kaltiala Heino R, Nilstun T, Sigurjónsdóttir M, et al. Paternalism and autonomy: a presentation of a Nordic study on the use of coercion in the mental health care system. Int J Law Psychiatry. 2002;25:93-108 pubmed
  14. Salander P. Bad news from the patient's perspective: an analysis of the written narratives of newly diagnosed cancer patients. Soc Sci Med. 2002;55:721-32 pubmed
    ..In this relationship information about diagnosis and treatment is more a means than an end. ..
  15. Thornicroft G, Slade M. Comparing needs assessed by staff and by service users: paternalism or partnership in mental health?. Epidemiol Psichiatr Soc. 2002;11:186-91 pubmed
  16. Tai M, Tsai T. Who makes the decision? Patient's autonomy vs paternalism in a Confucian society. Croat Med J. 2003;44:558-61 pubmed
    ..The head of the family, not the patient himself or herself, usually makes the decision, especially when the medical decision has something to do with a life or death situation. ..
  17. Cody W. Paternalism in nursing and healthcare: central issues and their relation to theory. Nurs Sci Q. 2003;16:288-96 pubmed
    ..In the United States, paternalism in health and human services is widespread and probably increasing with newly emergent forms...
  18. Tarrier N, Barrowclough C. Professional attitudes to psychiatric patients: a time for change and an end to medical paternalism. Epidemiol Psichiatr Soc. 2003;12:238-41 pubmed
  19. Edwards S, Kirchin S, Huxtable R. Research ethics committees and paternalism. J Med Ethics. 2004;30:88-91 pubmed
  20. Wheeler D, Szymanski K, Black A, Nelson D. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening. BMC Cancer. 2011;11:148 pubmed publisher
    ..In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making...
  21. Zimmermann H. [Shared decision in the emergency care: old wine in new bottles for informed consent?]. Praxis (Bern 1994). 2005;94:1531-4 pubmed
  22. Krassen Covan E. Un-informed consent. Health Care Women Int. 2004;25:699-700 pubmed
  23. Sulmasy D. Informed consent without autonomy. Fordham Urban Law J. 2002;30:207-20 pubmed
  24. Chapman S. Should smoking in outside public spaces be banned? No. BMJ. 2008;337:a2804 pubmed publisher
  25. Ho E, Bylund C. Models of health and models of interaction in the practitioner-client relationship in acupuncture. Health Commun. 2008;23:506-15 pubmed publisher
    ..model of health (biomedical or holistic) does not necessitate a particular model of health interaction (paternalism, consumerism, or collaboration), participants' attempts to tie these 2 realms together are important to ..
  26. Hubbard S. Disability studies and health care curriculum: the great divide. J Allied Health. 2004;33:184-8 pubmed
    ..The question is asked if curricula are preparing our future health care professionals to distinguish how to view each situation and each individual through the lens of the appropriate model. ..
  27. Hoerni B, Avril A. [What good? From benevolence to autonomy principles]. Bull Cancer. 2009;96:769-75 pubmed publisher
    ..In usual cases, traditional paternalism should be abandoned for allowing the patient to express his/her good and his/her choice for medical decision...
  28. Piker A. Balancing liberation and protection: a moderate approach to adolescent health care decision-making. Bioethics. 2011;25:202-8 pubmed publisher
    ..In the final section of the paper, I propose a moderate position that addresses both liberationist and protectionist concerns. ..
  29. Schmidt B. [The personally responsible person]. Gesundheitswesen. 2010;72:29-34 pubmed publisher
    ..Effective health improvement requires a new balance between personal and social responsibility. ..
  30. McGuinness D, Dowling M, Trimble T. Experiences of involuntary admission in an approved mental health centre. J Psychiatr Ment Health Nurs. 2013;20:726-34 pubmed publisher
    ..The findings suggest that the meaning of detention is a varied one that evokes an array of emotional responses for participants and highlights the need for a renewed way of thinking and doing concerning those subject to involuntary. ..
  31. Schramme T. Rational suicide, assisted suicide, and indirect legal paternalism. Int J Law Psychiatry. 2013;36:477-84 pubmed publisher
    ..To argue against indirect legal paternalism, the practice of legally preventing someone else to assist a person to perform a suicide or to be killed on ..
  32. Twiss S. On cross-cultural conflict and pediatric intervention. J Relig Ethics. 2006;34:163-75 pubmed
    ..The conclusion drawn is that Miller's position requires further nuance and development, and some recommendations are made toward that end. ..
  33. Sheu S, Huang S, Tang F, Huang S. Ethical decision making on truth telling in terminal cancer: medical students' choices between patient autonomy and family paternalism. Med Educ. 2006;40:590-8 pubmed
    ..The changes in decision patterns regarding the emphasis placed on patient autonomy versus family paternalism and the connection to related moral reasoning were subjected to focus analysis...
  34. Zamir T. The moral basis of animal-assisted therapy. Soc Anim. 2006;14:179-99 pubmed
  35. Schuster D. Personalizing illness and modernity: S. Weir Mitchell, literary women, and neurasthenia, 1870-1914. Bull Hist Med. 2005;79:695-722 pubmed
  36. Kagan P. Jo Ann Ashley 30 years later: legacy for practice. Nurs Sci Q. 2006;19:317-27 pubmed
    ..foundations of modern medicine, nursing, and hospital care in her pivotal book published in 1976, Hospitals, Paternalism, and the Role of the Nurse...
  37. Mohrmann M. Whose interests are they, anyway?. J Relig Ethics. 2006;34:141-50 pubmed
    ..There remains much to be done in defining and discerning basic interests and in distinguishing whose interests are on the table when decisions are being made for seriously ill and dying children. ..
  38. Harwood K. Egg freezing: a breakthrough for reproductive autonomy?. Bioethics. 2009;23:39-46 pubmed publisher
  39. Sahlsten M, Larsson I, Plos K, Lindencrona C. Hindrance for patient participation in nursing care. Scand J Caring Sci. 2005;19:223-9 pubmed
    ..For further development replication studies are needed, like additional studies of patients and significant others. ..
  40. Rauprich O. [Utilitarianism or communitarianism as the foundation of public health ethics?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2008;51:137-50 pubmed publisher
    ..Other more extreme proposals of communitarians, e.g. to exercise public-health police power and public-health paternalism, are to be taken with great care...
  41. de Vocht H, Nyatanga B. Misguided paternalism: a response to Gannon and Garland (2008). Int J Palliat Nurs. 2008;14:202-3 pubmed
  42. Breier Mackie S. Patient autonomy and medical paternity: can nurses help doctors to listen to patients?. Nurs Ethics. 2001;8:510-21 pubmed
    ..They play a central role in the care of dying people, yet they may find themselves disempowered by medical paternalism or ill-equipped in the decision-making process in end-of-life situations...
  43. Goldie J, Schwartz L, Morrison J. Whose information is it anyway? Informing a 12-year-old patient of her terminal prognosis. J Med Ethics. 2005;31:427-34 pubmed
    ..Small-group teaching is most conducive to this approach. The importance of positive role modelling is also emphasised. ..
  44. Scoccia D. Slippery-slope objections to legalizing physician-assisted suicide and voluntary euthanasia. Public Aff Q. 2005;19:143-61 pubmed
  45. Ortendahl M. Risk in public health and clinical work. J Med Ethics. 2007;33:246 pubmed
  46. Del Pozo P, Fins J. Islam and informed consent: notes from Doha. Camb Q Healthc Ethics. 2008;17:273-9 pubmed publisher
  47. Campesino M. Beyond transculturalism: critiques of cultural education in nursing. J Nurs Educ. 2008;47:298-304 pubmed
  48. Meise U, Frajo Apor B, Stippler S, Wancata J. [Coercion in Psychiatry - a taboo?]. Neuropsychiatr. 2011;25:44-50 pubmed
    ..An open and thorough debate about the meaning and meaninglessness of coercion and violence in psychiatric treatment would be necessary to prevent "routine violence" or the excessive use of force against the mentally ill. ..
  49. Hoffmann D. Choosing paternalism?. Med Ethics (Burlingt Mass). 2006;13:4, 12 pubmed
  50. Touwen D. Egg cell preservation and the right to die in the Netherlands: citizens' choices and the limits of medicine. Camb Q Healthc Ethics. 2011;20:449-57 pubmed publisher
    ..However, contrary to popular belief, not all Dutch ethical debate concerns end-of-life questions. ..
  51. Sjöstrand M, Helgesson G, Eriksson S, Juth N. Autonomy-based arguments against physician-assisted suicide and euthanasia: a critique. Med Health Care Philos. 2013;16:225-30 pubmed publisher
    ..It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible. ..
  52. Gampel E. Does professional autonomy protect medical futility judgments?. Bioethics. 2006;20:92-104 pubmed
    ..Nor do resource considerations change this fact, since they should not influence the properly patient-centered judgment about futility. ..
  53. Chorpening J. Genetic disability: a modest proposal to modify the ADA to protect against some forms of genetic discrimination. North Carol Law Rev. 2004;82:1441-81 pubmed