Paternalism in the name of autonomy

J Med Philos. 2013 Dec;38(6):710-24. doi: 10.1093/jmp/jht049. Epub 2013 Oct 24.


Different ideas of the normative relevance of autonomy can give rise to profoundly different action-guiding principles in healthcare. If autonomy is seen as a value rather than as a right, it can be argued that patients' decisions should sometimes be overruled in order to protect or promote their own autonomy. We refer to this as paternalism in the name of autonomy. In this paper, we discuss different elements of autonomy (decision-making capacity, efficiency, and authenticity) and arguments in favor of paternalism for the sake of autonomy that have been proposed in the bioethical debate. We argue that if autonomy is valuable, then paternalism for the sake of autonomy may be justified. However, policies allowing paternalism in the name of autonomy may be self-defeating.

Keywords: autonomy; bioethics; ethical theory; paternalism.

MeSH terms

  • Bioethics
  • Decision Making
  • Humans
  • Paternalism / ethics*
  • Patient Participation
  • Personal Autonomy*
  • Philosophy, Medical