There's no reason why David Patterson as an individual has to go along with it, though.
There are very powerful reasons why a Kennedy appointment would serve Paterson's political interests. Reid has made clear he wants Kennedy in the Senate. The incoming Obama Administration has been more veiled, but rumors swirl that they want it as well. Not surprising given that she would be by far the most helpful to the national party. Caroline can self-fund for 2010, which means more local money for Paterson who also must run in the same year. And he would appear on the ballot with Kennedy.
I still predict she will be selected. It's possible that Paterson may go the "caretaker" route, though. Kennedy has said she will run in 2010 whether she is chosen or not.
Personally, dynasties don't bother me. I'm more concerned that the strongest candidate possible is appointed. I'm not convinced that Caro is the strongest, but don't see a hands-down case for anyone else either.