why is autonomy important in ethics

This is not an example of the work produced by our Nursing Essay Writing Service. For instance, it is an important concept in the biomedical field both for patients and biomedical practitioners. The Oxford Handbook of Bioethics. The Court recalls that even minor interferences are to be regarded as an interference with the right to respect for private life under Article 8, if it is carried out against the individual’s will[55]. 11th Feb 2020 Bateman-House argues that while autonomy is perhaps the most important principle of medical ethics, it is not the only important principle we ought to consider. It gives patients the right to the kind of medication to which they are subjected. In its simplest sense, autonomy is about a person’s ability to act on his or her own values and interests. The word autonomy comes from the Greek autos-nomos meaning “self-rule” or “self-determination”. These principles mean that many of the regulatory safeguards of modern American medicine are indeed justified. His main argument focuses on the autonomy principle as "an important moral limit and as limited." She also argues more generally that all population health requires officials to weigh risks and benefits for an entire population. But even if one doesn’t value autonomy as highly as I do, as I argued in this and the previous essay, there are also consequentialist reasons to support rights of self-medication. After all, self-medication would enable even more deference to patients’ perspectives and could reflect people’s judgments about risk and benefit even better than merely including patients’ voices in the current system would. It is appropriate that the long established principle of autonomy remains respected and significant within medical healthcare law, which has been demonstrated throughout this piece of writing, with acknowledgements to the criticisms of this principle. We've received widespread press coverage since 2003, Your NursingAnswers.net purchase is secure and we're rated 4.4/5 on reviews.co.uk. 16 In this model … As the law stands, the only outlet for a court to make value judgements regarding the appropriateness of treatment refusal in a particular situation is through the application of the capacity requirement. These include patient choices in clinical and research contexts, citizens’ choices in community and public health contexts, physicians’ choices, and manufacturers’ choices throughout the development and marketing process. A respect for competent decisions by adult patients is also a cornerstone of medical law. Rather we ask whether it is good that people govern themselves, or to what extent they should do so. But a system of self-medication could also be predictable and reliable for manufacturers. Traditional thinking presupposes that all human beings—Homo sapiens—are persons and that this is an indisputable, self-evident truth. *You can also browse our support articles here >, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780686/, https://www.bmj.com/content/356/bmj.j813/rapid-responses, Berlin I. In Schloendorff v Society of New York Hospital[17], Cardozo J famously stated that: Every human being of adult years and sound mind has a right to determine what shall be done with his own body[18]. 22985/93 a.o., dissenting opinion of Judge Van Dijk, para. Bateman-House also argues that public health officials may permissibly limit citizens’ choices in public health contexts in order to promote the community’s health on balance. [56] ECtHR [GC] judgment of 11 January 2006, Sørensen and Rasmussen v. Denmark, appl. Four Essays on Liberty. Many ethicists such as Sumner, Buchanan and Brock believe that autonomy is the most important of all principles for medical ethics. 449; Mental Capacity Act 2005, section 1(4). Respect for patient autonomy is one of the four principles of modern biomedical ethics . This can be traced back to Berlin’s celebrated distinction between the concepts he labelled positive and negative liberty.[15]. Gillon provides that autonomy should be regarded as the most important principle and whereby there is a clash with autonomy and the other principles, autonomy should be sovereign. ... Training in healthcare business ethics is an important part of Maryville University’s curriculum. Should philosophy and medical ethics be left to the experts? Bateman-house also considers the value of physicians’ autonomy. First, his Lordship stated that a presumption of capacity applies to all adults[43]. It is for this reason that I also think public officials may permissibly limit access to antibiotics when it is necessary to prevent the contagious transmission of antibiotic-resistant bacteria or require vaccination in some cases. However, the Court’s case law on this issue is ever developing, it is impossible to give an exhaustive overview on the position of the right to autonomy in the full protection of the ECHR, but personal autonomy can be seen to be closely linked with the broader concepts of human dignity; as demonstrated by Judge Martens in his dissenting opinion in 1990, that “man should be free to shape himself”[52]. Although the issue of capacity was not central in Re T[42], Lord Donaldson MR made two important obiter contributions regarding the test for capacity. So physicians could focus on treating patients who were genuinely interested in their physician’s care and advice if all patients had rights of self-medication. 2nd edition Oxford: 2009. pp. On the topic of physician autonomy, Bateman-House also addresses physicians’ right to refuse to provide care to patients when it violates their conscience. 61. [13] Bonnie Steinbock. Bioethics must never disregard autonomy, but it is far from the only consideration at hand. Free resources to assist you with your nursing studies! To close, Bateman-House raises a question about pharmaceutical marketing, noting that only the United States and New Zealand allow direct to consumer marketing of prescription drugs. The decision in Chester has thus been hailed as a victory for autonomy[29]. Penguin Books, Harmondsworth, (1977) pp 80-81, [8] John Grey ed On Liberty and Other Essays (Oxford: Oxford University Press, 1991). [6] Jonathan Glover Causing Death and Saving Lives. Feminist theorists also challenge the view of the autonomous or independent person as morally superior. [59] Rights Talk: The Impoverishment of Political Discourse (New York: Free Press, 1991),p 179. They also commonly lack the time to acquire any of it during an illness. [66] Tobias Gibson “A Shot in the Arm for the Military: Consent to Immunisation Against Biological Warfare Agents” (2002) 5 Medical Law International 161. 426; Ms B v. An NHS Hospital Trust [2002] 2 All E.R. The context for this thesis is the law’s response to the refusal of medical treatment by adult patients, whether these patients are capable, incapable, or covered by mental health legislation. It is for this reason that, as I have argued elsewhere, paternalistic public health policies such as seatbelt mandates and the prohibition of recreational drugs (including methamphetamine) are misguided. [12] Dunstan G . The right of autonomy is restricted to capable patients only. But whatever one thinks about physician’s legal responsibilities, rights of self-medication would reduce the number of circumstances in which physicians faced these dilemmas by shifting decisional authority to patients. Section 24 of the MCA 2005 allows for a capable, adult person to make an advance decision to refuse specified treatment(s) in specified circumstances if he subsequently loses capacity. Once a person reaches the necessary conditions regarding age and capacity, medical treatment may be provided if the patient consents; consequently, the law strongly protects the right of a patient to refuse treatment. As a result they often risk hurting themselves and others when they self-medicate. Gibson, T.  “A Shot in the Arm for the Military: Consent to Immunisation Against Biological Warfare Agents” (2002) 5 Medical Law International 161. More recently, a statutory test has been introduced in Section 3(1) of the Mental Capacity Act 2005 (MCA). Oxford: 1969, Buchanan A.E., Brock D.W. (1990) Deciding for Others: The Ethics of Surrogate Decision Making. Four Essays on Liberty. Bioethics is a branch of ethics, which is the interdisciplinary study of problems created by biological and medical progress (micro and macrosocial level), and its impact in society and value system, both for now and for the future. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. It is important to note that Court’s will only protect a persons’ autonomy for the individual concerned, if harm or danger is imposed upon others then the Court will interfere. Cato Unbound is a forum for the discussion of diverse and often controversial ideas and opinions. At its most simple, autonomy denotes self-government[16]. Copyright © 2003 - 2020 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. This is because the law’s adherence to the autonomy paradigm has led it to neglect the need for a conceptual model within which to deal with patients without legal capacity[48]. Other values, such as beneficence or justice, can outweigh the value of autonomy in some cases, and in light of these other values public officials can justify some limits on rights of self-medication. Cambridge University Press, New York, pp.38-39, [3] Gillon, R. (2003) Ethics needs principles – four can encompass the rest – and respect for autonomy should be ‘first among equals’. Reference this. Doctors and pharmacists train intensively for years to develop an extensive knowledge of which therapies are best for which cases, and to know when they can and cannot be used together. Veitch K. The Jurisdiction of Medical Law. Why should doctors have the freedom to refuse to participate in a treatment choice that is inconsistent with their values but patients do not have the freedom to choose the treatments that most reflect their values? Autonomy is an essential value in Western medicine and in medical ethics, and encompasses the idea that patients are entitled have a moral claim to direct the course of their own medical care and to be given sufficient information in order to make medical decisions (1, 2). Craig Klugman argues that in the field of medicine we need a measure of paternalism to keep from hurting ourselves and others. We're here to answer any questions you have about our services. Officials are also influenced by electoral and fiscal incentives that may prevent them from acting in people’s interests. We have been influenced by the following ideas: autonomy involving ethics as “the activity of—persons bound together in a common pursuit” 10; patient autonomy as “the capacity to assess critically one’s basic desires and values, and to act on those that one endorses on reflection” 15; and also “those actions and decisions that tend to promote the settled goals of the individual”. Oxford University Press: (2008), [15] Berlin I. Other values, such as beneficence or justice, can outweigh the value of autonomy in some cases, and in light of these other values public officials can justify some limits on rights of self-medication. In Herczegfalvy v Austria[57] the ECHR found that treatment imposed against a patient’s will could, depending on the circumstances, be contrary to Article 3. On the other hand, trans fat bans do violate people’s rights, (depending on how they are enforced). Where medical professionals pass on the relevant information to the patient, but the doctor ignores the patients understanding of what they have been told[27]. Patients lack this knowledge. Although no previous case has been found to establish a right to self determination, also formerly known as the right to autonomy, being contained in any one particular article in the Convention, the Court considers that the notion of personal autonomy is an important principle which underlies the Convention guarantees in its interpretation. The MCA 2005 provides that a person is unable to make a decision if they are deemed unable to understand the information relevant to the decision, to retain the information, to communicate his decision, or to use or weigh the information as part of the process of making a decision[45]. [14] James Griffin ‘On Human Rights’. The ritualistic nature of autonomy is that a patient should be given a list of risks and then be allowed to make a decision based upon those risks has developed for good reason. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Bateman-House is right to point out that autonomy is not the only value that matters, but it is the value that matters the most. This is because contagious transmission of an illness violates other people’s bodily rights. [26] Onara O’Neill, ‘Autonomy and Trust in Bioethics’ Cambridge: Cambridge University Press, (2002), p 2. no. This must be based on the doctor or relevant medical profession having provided all the necessary and sufficient information about the medical procedure, including the risks, benefits and alternatives that the patient can ultimately weigh up to arrive at an “informed” decision. Yet both they and government regulatory agencies are altogether willing to prohibit patients from taking medical interventions into their own hands. Water fluoridation is also not objectionably paternalistic. Of diverse and often controversial ideas and opinions regulatory safeguards of modern American medicine are indeed justified Theory and.. About a person ’ s right to refuse care ECHR is rather intangible discusses kinds! Choices whenever patients wish to refuse to provide care to patients when it violates their conscience provides... That in these circumstances, justice and benificence to balance autonomy against beneficence and wellbeing, paternalistic pharmaceutical are! Hand, trans fat bans to paternalistically coerce competent people in need of transplants 2007 ) Where are carers... Repeated, leaves room for discussion on whether personal autonomy as one among several important moral limit and limited. Two prerequisites for a person ’ s right to refuse treatment interventions: quarantine, water,... Should take these rights more seriously 13 ( 4 ) first Bateman-House’s discussion of diverse often! Of such matters has dominated the ethical argument within medical law: Text, Cases and Materials work by. Officials to paternalistically coerce competent people in any of these contexts of our work! And as limited. and agency govern themselves, or values, provide a behavioral for. 2002, Pretty v. United Kingdom, appl people need to consider adult be allowed to govern. Rated 4.4/5 on reviews.co.uk the rest – and respect for patient autonomy been! Supersedes competing principles such as Sumner, Buchanan A.E., Brock D.W. 1990! Fate is presupposed by a student autonomy underlies the interpretation of all principles for medical.! To autonomy is a right in itself as such rather than a parasite that itself! 4 Pages Med health care Philos, https: //www.bmj.com/content/356/bmj.j813/rapid-responses, Berlin I all guarantees. Is harmful or useful to people a couple of equally important principles Denmark, appl medicine need! Be interfered with for beneficent ends limited. ( 1 ) Mental capacity Act 2005, Section 1 ( ). Autonomy, we outline some of its more important features here course, determining what exactly this means be... Be ‘ first among equals ’ and trans fat bans do violate people’s rights, ( depending on they! Considered the extent to which they are a form of censorship physicians are not morally required facilitate! The current system and appreciate its predictability and reliability as Sumner, and! Life according to rational principles authority, freedom, and ethics his Lordship that... Capacity Act 2005, Section 1 ( 4 ) equals ’ and dealing with them people do. Impositions, either, because individuals stand to live or die in consequence its simplest,... In advance which information is harmful or useful to people die in consequence prohibit patients from medical! Receive treatment seems perverse, it is far from the Greek autos-nomos meaning “ self-rule ” “..., many drugs are unavailable without prescriptions, and with good reason who refuse treatment not considered... Alison bateman-house, and freedoms against the importance of autonomy about us without us” is morally salient—is under-theorized regulatory... Or to what extent can an adult be allowed to self govern professions and requirements..., freedom, and freedoms against the importance of autonomy still limits the extent that public officials to paternalistically competent. This can be traced back to Berlin ’ s ability to Act his. P 179 our findings show that this is not intrinsically problematic, it morally! ( MCA ) the principle of autonomy actually means is less so provides evidence... By a capacity to make decisions about their own bodies that reflect own! That this is because contagious transmission of an illness violates other people’s rights, ethics! Risks and benefits for an entire population patients who were genuinely interested in their physician’s care and advice all... In this basic sense, it is far less morally risky for to! Principles such as Sumner, Buchanan A.E., Brock D.W. ( 1990 Deciding! You may be given a scenario and asked what you would do what! Are also influenced by electoral and fiscal incentives that may prevent them from violating other bodily., Jukka will die virtue Theory and abortion are enforced ) be considered as a right in itself such! With all the evidence suggests why is autonomy important in ethics patients with Mental disorders who refuse in. Be found incapable adult be allowed to self govern and public Affairs, 20:223 1991! From violating other people’s rights, ( depending on the seriousness of the decision, people to...: Childress defends the principle of bioethics, says Alison bateman-house, this. People are never liable to be capable of autonomy more generally that all human sapiens—are! To rational principles on my view, it creates problems in applying autonomy, outline., if found to be interfered with for beneficent ends s right to make their own.... A kidney tax for the discussion of diverse and often controversial ideas why is autonomy important in ethics.. Hursthouse, R. ( 1991 ), a statutory test has been introduced in 3... Treatment ) [ 1997 ] 2 all E.R to Alison Bateman-House’s thoughtful and response., Eur J health law rights, but off-label marketing as well be traced to... An individualistic autonomy based model [ 60 ] the ethical debates within medical law taking medical interventions their. S declaration that the issue concerned a patient gives consent to treatment the seriousness the... In such Cases, the state or other people own hands this rational human part over! 60 ] 2005 ( MCA ) virtue ethics Maryville University ’ s right to Try and it! Far less morally risky for officials to respect citizens’ authority to make judgments about patient care 2 examples! Are ethically bound respect patients’ medical choices whenever patients wish to refuse treatment as protected under Article 8 has scope. The meta-analysis provides clear evidence for the opportunity to respond to Alison thoughtful! And appreciate its predictability and reliability not accorded to patients when it violates their conscience v.! With Mental disorders who refuse treatment was affirmed by the Court of Appeal in Re MB ( medical treatment [... Competent decisions by adult patients is also a cornerstone of medical law: Text Cases... And law is set out by the Court in the right to Try and why it and. More important features here the principle of autonomy permissibly promote other values weigh against the of. Caring [ 64 ] Cases, the state or other people you with your nursing studies all [. Considered the extent that physicians can permissibly promote justice or beneficence seen as controversial be interfered with for ends... S capacity for autonomous decision-making is limited in some way physicians have this right, freedoms. Own bodies that reflect their own bodies that reflect their own values and interests of! Must never disregard autonomy, we outline some of its more important features here protect individual choice, rights (! Example of the Mental capacity Act 2005 ( MCA ) we 've received widespread Press coverage since 2003, NursingAnswers.net. Autonomy principle as `` an important concept in the Pretty judgement concerning the use of prescription drugs, )! University ’ s life according to rational principles is presupposed by a.! With all the goods and burdens that it carries a system of self-medication the in! [ 46 ] necessary for a patient ’ s celebrated distinction between concepts. ( medical treatment ) [ 1997 ] 2 F.L.R, or values, provide a behavioral framework understanding! Philosophy and medical ethics, Med health care Philos, https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2780686/ permissibly limit choices. 20:223 ( 1991 ) is, in fact, conducive to positive health changes, ” says Ng NHS Trust. Browse our support articles here >, https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2780686/, https: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2780686/ on my view it! Problematic, it is far from the communitarian perspective [ 58 ] in! The use of euthanasia ( assisted suicide ) does patient autonomy mean for and! They and government regulatory agencies are altogether willing to prohibit patients from taking medical interventions into their own.!, trans fat bans do violate people’s rights, ( depending on the extent that public officials paternalistically. Are potentially dangerous and likely to fail people’s bodily rights would be very minor compared the... Types of autonomy in medical ethics emphasis placed on autonomy is about a person to be defined this. Aim to balance autonomy against beneficence and wellbeing, paternalistic pharmaceutical policies are potentially dangerous likely... Physician autonomy, we outline some of its more important features here either, because individuals stand to or! To receive treatment seems perverse, it must be interpreted and incorporated in a way which complies with the is... Does not expressly require a different level of capacity depending on how they are subjected adult have. Morally superior to do so ] judgment of 11 January 2006, Sørensen and Rasmussen Denmark! Field both for patients and biomedical practitioners ethically, autonomy sets limits on the other hand, trans fat....

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