Autonomy in Medical Ethics: Issues of Informed Consent

Abstract

Following the previous general discussion of autonomy in philosophical and ethical theory, I will now turn to medical ethics, and set out how the principle of respect for autonomy has been interpreted and elaborated in that field. In standard works and textbooks on medical ethics, ‘autonomy’ is generally understood as the patient’s right to self-determination within the context of medical and research practices. As mentioned earlier, this right to self-determination is primarily a negative right to non-interference: the right to make decisions concerning one’s own life for oneself without being controlled by others. The principle of respect for autonomy thus functions as a moral rule that protects patients from unwelcome interference by physicians and other health care professionals and has become a principle that guides interactions between patients and care givers. Assuming this interpretation, the medical ethical literature discusses various aspects of and problems related to patient autonomy. Who has this right to self-determination? How can we make sure patients’ rights are respected? Can anything justify interference with these rights, and if so, what? What constitutes a free or autonomous choice? When is a person incapable of making such a choice, and how can his rights be respected when he is unable to exercise them?