In paternalism, who takes over decision-making when a patient cannot decide (altered or SI)?

• A. The patient
• B. A Healthcare Professional
• C. The family
• D. The nurse

Answer: (B)

In paternalism, when a patient can’t decide due to altered capacity, the decision-maker is the healthcare professional. The clinician uses medical judgment to determine what’s best for the patient, aiming to protect welfare and prevent harm, especially in urgent situations. The patient’s autonomy is temporarily set aside because they lack the capacity to make informed choices. The family may provide input or have knowledge of the patient’s wishes, but they do not unilaterally decide in paternalistic care. The nurse follows the care plan and supports the clinician’s decisions, rather than independently choosing the course of action in this approach.