[Paternalism in medicine: illustrated by the example of fiber optic bronchoscopy]

The question of when and how it is permissible for a physician to take a paternalistic approach to a patient is discussed. In the introduction, the physician-patient relationship is presented based on the empirical example of fiberbronchoscopy. An attempt to define the term paternalism more precisely leads to the result that not only are patients who are very limited in their autonomy (e.g. psychiatric and intensive-care patients) treated paternalistically, but that the patient status as such leads to a certain degree of paternalism. The example given is interpreted in detail and the pragmatic attitude of the physician to the patient "object" is criticized. Finally, a demand is made that the physician-patient relationship be a partnership, in which the physician appeals to the patient's autonomic components, addresses and encourages them. This latter approach is seen as an alternative to paternalism.