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In its broad definition, paternalism refers to acting in what is determined to be someone else's best interests, either without seeking the individual's input or ignoring his or her stated preferences. In common usage the word carries a negative meaning, implying that an adult is being treated like a child. (The root of the word paternalism actually is the Latin word for "father.")
Medical paternalism was exercised much more often in the United States before the emphasis on patient autonomy that arose in the 1970s. It was often expressed in a "Doctor knows best" situation, in which the patient was either not well-informed, not asked for input in medical decision making about his or her own care, and/or simply ignored.
Defining paternalism related to nursing dilemma? Which specific nursing dilemma's are you referring to?