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Paternalism

Paternalism is overriding or limiting a person's choice for their own good.

Updated 19 October 2026 (1 minute read)

Summary

Paternalism is interfering with someone's choices to protect them from harm to themselves, rather than to protect other people.
Soft paternalism is the view that interference is justified only to check that a person is acting voluntarily and with knowledge, so once they understand the risks they must be allowed to go ahead.
Hard paternalism holds that, at least sometimes, it may be permissible to prevent someone from acting even when they know the risks.
Paternalism sits in tension with autonomy, because protecting someone's welfare can mean overriding their right to decide.
In medicine the question usually turns on capacity, which is judged one decision at a time.

In practice

The Mental Capacity Act 2005 says a person is not to be treated as unable to make a decision merely because they make an unwise decision (section 1(4)).
The same Act says a person must be assumed to have capacity unless it is established that they lack it (section 1(2)).

Interview questions

What do you know about the difference between soft and hard paternalism?
A patient with capacity decides to leave hospital against medical advice, and you think they are making a mistake. What would you do?
Can overriding someone's choice ever be justified for their own good, and what are the strongest arguments against it?

Sources

plato.stanford.eduplato.stanford.edu/…/paternalism
legislation.gov.uklegislation.gov.uk/…/1

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Capacity Capacity is the ability to make a particular decision for yourself at the time it needs to be made. Best interests Best interests is the test used to make a decision for someone who cannot make it themselves. Principle of least harm The principle of least harm says that when every option carries some harm, the one that causes the least should be chosen. Informed consent Informed consent is a patient's agreement to a treatment, given freely, with capacity, and with the information they need.

More NHS hot topics, medical ethics case studies and medical school interview questions are in AlphaMED Resources, which we add to and update through the application cycle.