Abstract
It is the traditional argument that medical paternalism can not appear and work until a patient's right to self-determination disappears and stops working. We have, however, an alternative argument : a patient's right to self-determination and a doctor's paternalism are two ways to maintain and / or increase a patient's subjective interests, and which way to choose depends on the circumstances around the patient, including, especially, expected interests of proposed medical treatment, and his restricted competency. The traditional argument is simple and clear based on the absolutism of self-determination, but lacks a sensitive tool to balance a patient's autonomy and a doctor's consideration. Contrarily, the alternative argument is furnished with the tool, but its application is often unclear because it is based on the relativism of self-determination and paternalism.