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The traditional role of the doctor as one who decides for others is defended in paternalistic medical theory, but is now severely limited by the doctor’s legal obligation to obtain the consent of the patient before medical procedures are carried out. Changes in the French code of medical ethics show that the therapeutic relationship is, in line with political liberalism, changing with the times. Does this necessarily mean that the arguments traditionally used to justify medical paternalism are unfounded? In this article, the doctor-patient relationship is examined through the analysis of the trust which is built up during the therapeutic relationship and which allows the intuition characterising the paternalistic model to remain operative within a highly liberal framework.