Essay

For centuries, physician beneficence went unchallenged as the first and foremost principle of medical ethics. The doctor knew best and was to have the final say on all medical decisions. This paternalistic approach focused very little, if at all, on the rights of a patient to dictate their medical choices on the basis of their own thoughts and decisions. However, in the last half century there has been a substantial shift from paternalism to the belief that individuals should have control over their own bodies and should be entitled to make their own medical choices. This belief is rooted in the principle of autonomy, and it is this ethical principle that is enshrined in Cardozo’s dictum. In our discussion, we will examine the principle of autonomy and assess it’s predominate on medical ethics as a theory.

The principle of autonomy derives its roots from the philosophy of Immanuel Kant. Kant developed a series of categorical imperatives that all individuals should act in accordance with. These are a set of absolute rules that should be followed regardless of desire or circumstance. One of these was the principle of humanity, the belief that humanity is an intrinsic good and this good could not be set aside for any consideration. The principle of humanity holds that individuals should not be treated as a means to an end but only as ends in themselves. This belief can be translated into “do unto others as you would have them do unto you”. It is apparent that an individual wishes to be treated as an autonomous agent, one that is capable of holding beliefs and values and who can make choices on the basis of these. When an individual made a choice, they would wish for this choice to be regarded as absolute. It therefore follows that ...

... middle of paper ...

...sideration. The law attaches great importance to the principle of autonomy by making it illegal to conduct a procedure or undertake medical treatment without the patient’s consent. However the principle of autonomy is not absolute, law and morality recognise that there are situations where a person’s autonomy will not be the deciding factor. If the agent wishes to take a course of action that would cause them substantial harm, then it is illegal for any third party to comply with their wishes, irregardless of the fact it is done with their consent. We must also recognise, that our ability to exercise our autonomy is dependent on the actual ability of a health care provider to meet these choices. In reality, limited resources limit a patient’s ability to exercise their autonomy, since some patients will be left with little, or no choice, over their treatment options.