The principle of respect for autonomy does not apply to people not in a position to act in an autonomous manner. This means that infants, suicidal people, and drug-dependent patients may be validly controlled on the grounds of beneficence to protect them from harm.1 Under the principle of beneficence, the nurse may legitimately restrain a patient from exercising his or her autonomy by trying to jump out a window. But people judged mentally incompetent are still capable of making autonomous choices about what they want to eat or what clothes they wish to wear.1
The constraint of a person’s autonomy is permissible when the person’s choices and actions infringe on the rights and welfare of others.8 Public health officials have detained patients with infectious tuberculosis to prevent the spread of the disease. More controversial was the holding of more than 200 non-infectious people because they were noncompliant with treatment for periods of up to two years as late as 1993 in New York.9
The intentional limiting of patients’ autonomy for their own good is the definition of paternalism.
