Medicine & Ethics

The Importance of Autonomy in the Medical World: Why a Patient’s Decision Matters

By Rachel Prince, YouthCare Connect

Autonomy is the patient’s ability to make their own decisions concerning their medical care. The role that autonomy plays in the medical world seems unclear. To what extent should autonomy reach in the medical world? It is agreeable to say that licensed medical professionals may have the best decision in a patient’s wellbeing, but an informed decision from a patient is made in their own interest. Autonomy has gradually become an implemented practice around the world, however, it was not always a choice for patients.

History of the Practice of Autonomy:

For the last 2,400 years, autonomy was not a known practice in the medical world. Physicians and doctors assumed authority over the patient’s medical journey and expected patients to be obedient to instructions. Though these rules are expected in today’s world, they are limited to a certain extent. In the last hundred years, this practice has evolved, changing the physician-patient relationship. Due to numerous changes in research and clinical practice, autonomy became monitored under an informed consent doctrine. This doctrine allows doctors and physicians to inform their patients of all possible treatments and to encourage their patients to make an informed decision for their well being before going forward with the treatment. Philosophers emphasized that autonomy carries importance because of the patient’s right to advocate for themselves–considering their treatment option affects them the most. Though their decision may go against the physician’s duty to act in the patient’s best interest, the decision is entirely up to the patient.

The Different Views on Autonomous Decisions:

There are multiple different views on the topic of personal autonomy. An autonomous individual makes decisions based on their own personal beliefs and information. In contrast, a diminished autonomous individual would make decisions based on another person’s beliefs and ideas, rather than thinking for themselves. If a person makes a decision based on persuasion or manipulation, then their decision is not autonomous. The same applies with an individual who has views or beliefs which do not align with each other or has been uninformed of all of their possible treatments with all the needed information (Varelius). If a patient does decide on a treatment which does not have their best interest in mind, then their intrinsic value is harmed.

The Role of Intrinsic Value:

Intrinsic Value in a medical context refers to the idea that a person’s life has worth and must be treated regardless of external factors, such as their productivity or social contribution. A patient may make an autonomous decision towards their treatment, and they might do this considering their job or contribution to society. The patient must be treated despite the situation because of the ideal of intrinsic value. The patient’s background or occupation should not matter, because they still must be treated no matter what (Duncan). Many people perceive healthcare as something that is dependent on external values, like occupation, financial status, or social status. These ideas are only efforts to promote the idea that some people should be “more healthier” than others. Due to these ideas, autonomy is no longer an option for patients because individuals believe their intrinsic value when it comes to healthcare is “less than others”, and there would not be a point in treating them.

The Effect of Autonomy of Patients:

Hasini Namala, one of the team members on Synapse, a student-run weekly news outlet, shared her experience with a genetic disorder which caused her growth to accelerate faster than usual at the age of 13. She was estimated to be 6’4 after puberty. This caused her mental health and her emotional well-being to deteriorate because of the constant looks and whispers she got. The average height of an Indian female is about five feet, so naturally, Hasini would be judged by family and friends everywhere she went. Hasini was then presented with a solution, which was a surgery to close the growth plates in her knees. Doctors in the United States informed Hasini that there was a tremendous risk in going on with the surgery with the sole purpose of treating her mental health, so instead, Hasini went to India and underwent the surgery. Hasini was informed of the potential risks with her treatment and still went on with it because she believed that it was the best decision for her.

The Future of Autonomous Decisions in the Medical World:

Autonomy is not only a practice for physicians, but for a patient to feel trusted and responsible to make their own informed decisions on their future. When patients feel empowered to make their own decision, they feel in control of their future. We all are born with the right to make our own decisions, and healthcare should not be the factor that strips that away.