Abstract

The Nature and Scope of patient's autonomy Hossein Atrak Maryam Khoshdel Rohani Abstract One of the most challenging issues in medical ethics is the nature and scope of patient autonomy in treatment process. Autonomy that it usually is defined as independence or self-government, is the respect to independence of a patient and his right to choose the treatment and other medical attentions. Autonomy has two positive and negative aspects: The negative aspect is that the patient's independent decisions should not be violated by others; the positive aspect, on the other hand, includes a respectful behavior in the presentation of information and facts, confidentiality, informed consent, and helping the patient with enough understanding and support so as to protect his independent decision making. The important question is what is the scope of the patient's autonomy? It seems that the principle of individual autonomy is not an absolute principle but it can be overturned in some circumstances. The principle of autonomy may be revoked at least by the principle of nonharming oneself or others. Although the patient has no moral right to harm himself by his decision, the main argument in the question of patient's autonomy in medical ethics is not the moral value of the decisions made by the patient, but the doctor's responsibly regarding the patient's decisions. Thus, whenever the decision made by the patient harms to him, in the case of patient insisting on his decision, other people have no right to prevent him from exercising his will. This is because of a moral point of view that the professional responsibility of the doctor towards the patient is defined in terms of benevolence. For a person who wants to observe the moral code, being benevolent is a matter of a person who asks for help in the first place, and if/ when a person refuses to receive help or benevolence, other people have no obligation towards him. Indeed, the foundations of regarding the principle of respect for patient would be respect for whatever decision the patient may make, even if the decision might seem unwise or harmful as far as the doctor is concerned. Keywords Patient Autonomy, Physician, Benevolence, Informed Consent