Biomedical ethics: Patients' rights

Autonomy and information

Autonomy means self rule. An autonomous person acts in accordance with a freely chosen and informed plan. This concept of autonomy has been elaborated in the medical world over decades and has largely replaced unhealthy paternalistic attitudes on the part of healthcare professionals that used to be common and tolerated. A person of diminished autonomy is, in at least some respect, controlled by others or incapable of acting on his or her chosen plans of action. An autonomous person must act intentionally, with understanding and without controlling influences. In addition, a person may choose to act voluntarily under the influence of an authority, such as a religion. Respecting autonomy means respecting a person's capacity to act autonomously and to treat them so as to allow them to do so. This is the cornerstone of any charter of patient rights.

Five conditions for informed consent

• Disclosure of information

• Understanding

• Voluntariness

• Competence

• Consent

Information which is put on the person's file is therefore not merely something which needs to be explained in terms the patient can understand and act upon, but is in fact owned by the patient. This question of ownership is legal; although the physical file or computer may be owned by the doctor or hospital, the information contained is owned by the …