Respect for Autonomy

The Principle of Autonomy in Health Care

The principle of autonomy has been and remains to be one of the most frequently used principles when doing a biomedical ethical decision . It is true that Beauchamp and Childress cited four principles namely autonomy , beneficence , justice , and non-malenficence , and stated that these four principles are on equal footing in process of ethical justification . Nevertheless , the principle of autonomy seems to have a special place in ethical discussions because of its operative definition , that is , informed consent (p . 77 . Informed consent has gained ground

in important documents such as the Nuremberg Code and the Helsinki Declaration and for very understandable reasons : most if not all of the inhumane medical procedures happened due to lack of informed consent . From the abuses of the Nazi doctors to the Tuskegee Syphilis experiment , gross human violations happened since medical practitioners did not think it was necessary to involve the patients in deciding about their situation . So what exactly is the principle of autonomy and how is it expressed through informed consent

Autonomy is defined as self-rule that is free from both controlling interference by others and from limitations , such as inadequate understanding , that prevent meaningful choice (p . 58 . As such , two conditions ought to be present for autonomy to be present : liberty (independence from controlling influences ) and agency (capacity for intentional action (p . 58 . Translated in medical practice , this refers to the patient 's or research subject 's right to decide for himself /herself and not being hampered by ignorance or coercion in this decision-making process . From the perspective of the medical practitioner 's responsibility , this could then mean telling the truth to the patient , making sure that consent is obtained before any medical procedure or intervention , safeguarding confidential information presenting all the available medical options , respecting patient 's privacy , and many others (p . 65 . All these point to one thing : the acknowledgement that the competent patient remains to be the best person to decide for himself /herself , and such a capacity for decision-making could never and should never be taken away from him /her by anyone

Autonomy has best been operationalized by informed consent . Informed consent refers to an individual 's autonomous authorization of a medical intervention or of participation in research (p . 78 . It also means complying with the social rules of consent in institutions (p 78 ) before proceeding with a medical procedure /intervention Specifically , informed consent is present if all these following elements are present : the patient is competent to act , receives a thorough disclosure , comprehends the disclosure , acts voluntarily , and consents to the intervention (p . 79 . Indeed , gaining the patient 's informed consent has been an important step in any clinical trial . This means that anyone who is involved in a clinical trial knew exactly what the trial is about , what the implications of the trial are on his /her own well-being , what the procedures are , and what his /her involvements means for the trial . On the event that the patient wishes to...