Autonomy

Welcome back! In this video, we'll talk about the ethical principle of autonomy. Autonomy refers to the patient's right to accept or refuse treatment, given that the patient has all the facts regarding their treatment.

This means that the physician is required to inform the patient about the treatment provided, as well as the risks and benefits associated with it. They should also discuss alternative treatments. However, the decision to accept or refuse the treatment ultimately lies with the patient, and they should make that decision without any influence from the physician.

Therefore, the physician should not sway the patient's decision or alter it. For example, let's say that we take a blood sample from a patient who is complaining of fatigue, and we find very low platelets and red blood cells (RBCs), along with very high white blood cells (WBCs). This is highly suspicious of leukemia.

The physician then goes back to the patient and explains that their findings are consistent with leukemia, recommending a bone marrow biopsy to confirm the diagnosis. Now, legally and ethically speaking, here is where the physician's job ends; they have explored the causes, discovered the diagnosis, and provided the management options to the patient. Autonomy gives the patient the full right to accept or refuse a marrow tap.

If the patient refuses the bone marrow biopsy, this could lead to worse complications and even death. In this situation, the physician must explain this outcome to the patient. However, the treating doctor must respect the patient's decision and not judge them or attempt to alter their choice.

They can explain that it's a bad idea, but that is as far as they go. Now, autonomy can work both ways. The physician can also have autonomy.

For example, if a pregnant woman is in her third trimester and requests a cesarean section from the treating physician, but the doctor knows that this patient can deliver vaginally without any problems and that there are no medical reasons for a cesarean section, the physician can exercise their own autonomy and refuse to provide this treatment since it is elective and optional. And here's a small quiz: try to see whether or not the patient in this scenario was given autonomy. All right, guys, that's all I have!

Thank you so much for watching, and I'll see you later!