Which statement best defines autonomy and paternalism in nursing ethics, with a clinical example illustrating the difference?

• A. Autonomy is the patient’s right to make informed decisions about their care; paternalism is when the clinician overrides those decisions in the belief it serves the patient's best interest.
• B. Autonomy means the clinician decides what is best for the patient; paternalism means the patient makes decisions with full information.
• C. Autonomy refers to privacy rights; paternalism refers to confidentiality concerns.
• D. Autonomy is legal capacity; paternalism is about policy compliance.

Answer: (A)

Autonomy means honoring a patient’s right to make informed decisions about their own care. Paternalism is when a clinician overrides those decisions because they believe it serves the patient’s best interests.

In a clinical example, imagine a patient who has decision-making capacity and declines a recommended treatment after receiving full information about risks, benefits, and alternatives. Respecting autonomy means supporting the patient’s choice, providing further information as needed, and not coercing them. Paternalism would involve pressuring or forcing the treatment regardless of the patient’s wishes, or taking actions to override their decision.

The other statements don’t fit because they mix up the meanings: autonomy as the clinician deciding what’s best is a paternalistic stance, not autonomy; linking autonomy to privacy and paternalism to confidentiality confuses decision-making rights with information protection; and equating autonomy with legal capacity or paternalism with policy compliance misses the ethical distinction between respecting a patient’s choices and overriding them for perceived benefit.