Autonomy as a principle in medicine, applies where an individual is granted the conditions to make an independent decision with regards to their health. The physician has the responsibility of creating a environment for the patient in making an autonomous choice. Further, the physician should make an autonomous decision on ethical dilemmas facing them with regards to administering certain procedures on their patients. This choice afforded to both the physician and the patient raises the ethical dilemma whether an individual should cause harm to oneself or others in line with the autonomy principle.
The medical field is a sensitive occupation and is often rife with cases of conflicting codes of ethics when it comes to handling of certain cases. While the patient is granted the right to self determination, the physician should be empowered to decline against certain types of treatments and procedures after adequately informing the patient of an alternative course of action. The right of the patient to autonomously choose should not be imposed upon the doctor, as in doing so, the doctor comes to harm with issues of guilt and trauma in some instances.
The doctor on the other hand, being in position of help to the patient should not cause harm to them by way of administering a wrong procedure, or failure to conduct a procedure which would have otherwise saved their life. The principle of do good and no harm should apply in this case. (Stiggelbout, 2004)
According to the principle of the common good therefore, the autonomy principle should not be used as an excuse to do harm to one-self or to the others; rather, it should be utilized as a tool for making the best decision in the prevalent circumstances. Liberty of choice of an individual should be utilized to the common good of both the patient and the physician and not to the detriment of either. Further the principle of double effect provides the rationale against which one must weigh their actions in the case of anticipated harm. Overall, if at all one must do harm, they must do it unintentionally, and its benefits must outweigh it detrimental effect.
References
Stiggelbout, A. M., Molewijk, A. C., Otten, W., Timmermans, D. R., Bockel, J. H., & Kievit, J. (2004). Ideals of patient autonomy in clinical decision making: a study on the development of a scale to assess patients’ and physicians’ views. Journal of Medical Ethics. doi:10.1136/jme.2003.003095
