Is the narrow concept of individual autonomy compatible with or in conflict with Evidence-based Medicine in obstetric practice?: A philosophical critique on the misapplication of the value concept “autonomy”

Abstract

Summary Introduction In spite of rising caesarean section rates there is no better obstetric outcome but sustained problematic consequences for women and infants. This puts professionalism of obstetricians into question. Hypothesis It is assumed that current obstetric practice acts against better medical knowledge (Evidence-based Medicine) by misapplying the value concept of “autonomy”. Method By method of values clarification the vague and open context term of autonomy is critically examined and reduced to the concrete consequences of its (mis)application in obstetrics. Findings Evidence-based Medicine is not adhered to in the name of an unquestioned and vague autonomy concept. Conclusion Rational autonomy based on inquiry and integrated in a caring relationship between the parturient woman and her obstetrician (principled autonomy) calls for responsible professionalism (EBM). The critical expertise of obstetricians and midwives is highly relevant to enable pregnant women to make rational, informed, and consequentialist decisions in order to not being abandoned to individualised responsibility.