The main objective in healthcare is to ensure that the patients get all the attention they need and that they benefit from the services provided to them. However, there has, for a long time, been the debate of informed choice. This is where the patients are allowed to make a choice of the kind of care they need after being informed about it. Patient autonomy came as a result of this. The essay below looks at the advantages and disadvantages of patient autonomy in healthcare.
Pros and Cons of Patient Autonomy
Introduction
Long gone are the days when patients would just go to the hospital and get the services then proceed home to comply with the medication or the advice offered to them. As people have become more informed, they want to be more informed in the decisions made about their bodies and their health. It first came in as a way of informed consent where the physicians would just inform the patients on the kind of health services being offered to them. In the modern world, it has now become a matter of agreement where the patient has partial control in the kind of services offered to them. This is called patient autonomy, and can be defined as the practice where the patients have the power to make the decision on the kind of health care services provided to them (Davies and Elwyn, 2008). In any case, there are the advantages and disadvantages of this patient autonomy. The essay below looks at this issue in greater detail.
Pros of Patient Autonomy
There is nothing as good as an individual having the sense of control over one’s own life. This brings in a feeling of independence and power over the course of one’s life. This is what patient autonomy offers the patients. Rather than have decisions made concerning their bodies, the patients are given a responsibility to make critical decisions that affect their lives (Mikulak, 2012).
This concept is better explained by the self determination theory as explained by Mikulak (2012). This is a general theory of human motivation which explains how the psychology of the human mind works in bringing motivation to do things. As such, it defines and explains what motivates people to act and behave the way they do under different circumstances. This theory has it that there are three psychological needs that need to be satisfied for the people to have healthy behaviors in the long term. These include the sense of control of one’s own ideas, which is the sense of autonomy. It also allows the individuals to feel that they have competence and are effective in making decisions. Lastly, it makes the people feel that they are well cared for by other people.
After looking at the provisions of this theory, it can be seen why the patient autonomy is such a pertinent issue in the modern day medicine. The patients, as with all people on the planet, have the feeling that they need to have some control over their own lives. They need to feel that they can make decisions that affect their health and that these decisions are respected and followed. Therefore, giving them the chance to experience the control is vital to the health care profession.
There is also another perspective from which the issue can be approached. It is well known that the physicians and other health professionals are bound by their oath of service to maintain patient confidentiality and act ethically towards them. As such, it might be assumed that there is no need as to why the patients should be worried. They should relax and enjoy the services since they are well aware that the medics have their interests at heart. Well, this is not always the case. According to a study carried out by Stiggelbout et al (2004), there is the need to observe the concepts of the Socratic autonomy and procedural independence. This holds that there is some independence that should be extended to the patients. This is the reason as to why patients or their dependants have to sign an agreement before some procedures are carried out, such as surgical processes. Therefore, this means that the patients have to enjoy a form of autonomy.
One of the advantages of the independence is that it allows the patients to make critical decisions that affect their lives. For instance, there are risks that the patients are exposed to when they undergo some of these procedures, such as surgical processes. It would only be fair to ensure that they are well informed about these risks so that they can make the decisions in accordance with the severity of the matter. It is not in order for patients to be taken through risky procedures without being informed about the dangers that they are exposed to. As such, they should be given the opportunity to make decisions that affect their lives.
Cons of Patient Autonomy
It is commonly said that absolute freedom destroys freedom absolutely. This is to mean that some of the actions might be taken in a bid to improve the lives of people but they end up leading to the downfall of the people. This is the concern that anti-patient autonomy campaigners have. They have the feeling that the patients might be given the autonomy but use the decision making ability in the wrong manner. Some of these disadvantages are as indicated in the paragraphs below.
Davies and Elwyne (2004) have it that if patient autonomy is over-emphasized, there is a very high possibility that the more educated and affluent people would be in a position to exercise the right. However, the people who are experienced in making the preferences and who have the resources to make the right choice are withheld from doing so. In other words, it can happen that the patients feel that they are well informed and so can make the decisions that affect their lives. However, they might not have some of the specialty or specific skills that the doctors and other physicians have. Nevertheless, the assertion of the patient autonomy has it that the patients are to make the decisions about their health. As such, the doctors have nothing much to do but to follow the desires and recommendations of the patient even if the latter might cause some problems to the health of the individuals. For this reason, it can be seen that patient autonomy works against the overall good of the patients.
Uncontrolled patient autonomy can be quite disastrous. This is mainly because it is well known that the decisions made by individuals are guided by the cultural and the social backgrounds of the people. Therefore, they might make some decisions which might not be necessarily beneficial when it comes to the health matters. Again, it is known that the patients do not have the specialization that the trained medics have. As such, it can not be wholly upn them to make health related decisions. In as much as they might be informed, there is still an aspect of healthcare that they do not understand, and this is the area in which they need much guidance and instruction. If this is disregarded and the medics are forced to follow the decisions of the patients, it goes without saying that there will be a major hitch in the healthcare profession. This should not be allowed to happen under any circumstances. This is the reason as to why patient autonomy should be “tempered with steps to enable less powerful social, cultural and economic groups to contribute to decision making and to support individuals who may feel abandoned by having decisional responsibility transferred to them” (Davis and Elwyne, 2004).
After looking at this perspective, it can be argued that patient autonomy is good since it helps in transferring the decision ability to the patients. Nevertheless, it cannot be denied that if not well implemented, it can compromise the quality of health care services offered to the individuals. This is the reason as to why the researchers call for a model of optional autonomy which is a form of shared responsibility in decision making. This can be enhanced by having recommendations for practice, policy, education and research. Autonomy is good, but if not controlled can be the cause for a major crisis in the health care profession. There is no reason as to why people should be given the responsibility to make decisions in an area where they are not well or fully informed. There should be a form of control in terms of the decision making process.
Conclusion
Human beings are social creatures but they have a very high regard for their independence. Everyone wants to feel adequate enough and competent to make the decisions affecting their lives. This need for autonomy spreads to the healthcare profession where the patients want to participate in making the decisions that affect their health. However, the issue of patient autonomy has its merits and demerits. These have been addressed in the above essay. It has emerged that the main advantage of patient autonomy, besides sharing the decision responsibility, lies in the fact that it allows the patients to feel that they are in control of their lives. They feel that they are competent enough to make decisions that affect their lives. however, there are also the negative effects of the same. This is mainly because the practice draws the decision making responsibility from the people who are more equipped in the same and transfers it to those who might not make very appropriate decisions. This implies that the care of patients can be compromised or enhanced by the manner in which the decisions are made. Otherwise, it appears that partial patient autonomy should be the way to go.
Davies, M. & Elwyn, G. (2004). Advocating Mandatory Patient Auitonomy in Healthcare: Adverse Reactions and Side Effects. Health Care Analysis, Vol. 16(4), pp. 315-328. Retrieved on 2nd August 2012 from http://www.ncbi.nlm.nih.gov/pubmed/17975729
Mikulak, A. (2012). Supporting Patient Autonomy is Critical to Improving Health. Association for Psychological Science Press Release. Retrieved on 2nd August 2012 from http://www.psychologicalscience.org/index.php/news/releases/supporting-patient-autonomy-is-critical-to-improving-health.html
Sitgglebout, A. et al. (2004). Ideals of Patient Autonomy in Clinical Decision Making: A Study on the Development of a Scale to Assess Patients’ and Physicians’ View. Journal of Medical Ethics, Vol. 30(3), pp. 268-274. Retrieved on 2nd August 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1733851/
