Autonomy in Medicine
Finneaus Parker
National University
February 8, 2013
Dr. Schlitz

Autonomy is the “personal rule of the self that is free from both controlling interferences by others and from personal limitations that prevent meaningful choice” (Pantilat, 2008). Autonomous individuals act intentionally, with understanding, and without controlling influences. Respect for autonomy is one of the fundamental guidelines of clinical ethics. Autonomy in medicine is not simply allowing patients to make their own decisions. Physicians have an obligation to create the conditions necessary for autonomous choice in others. For a physician, respect for autonomy includes respecting an individual’s right to self-determination as well as
Advance Directives are oral or written instructions regarding an individual’s choices for what medical care is to be given during a future illness when the person articulating such choices is no longer able to express his or her desires (Ethics Manual, 1998). Advance directives seek to respect patients’ values and preferences to direct their care when they no longer may be capable of making health care decisions. Written directives are preferable, since they are less easily challenged and, if executed properly, have legal standing.
As extensions of their patients’ autonomy in decision-making, clinicians are expected to treat advance directives with the same respect as they would with other patient choices. If the provider disagrees with the patient’s choices, he or she has an ethical obligation to inform the patient when the document is executed, and to either resolve the conflict, or arrange for transfer of care. Regardless of the conflict at hand, the autonomy of the patient is the most imperative choice both parties can engage in.
Modern medicine is highly specialized, and technological interventions are commonplace, allowing people with chronic illnesses to live longer lives. As illnesses progress and the burdens of life-maintaining interventions increase, patients often exercise their autonomy by