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The misuse of autonomy in ethical decision-making – time for a change?

  • Monica Crugel (a1), Adrian Treloar (a2) and Rafael Euba (a3)


Concepts of personal autonomy and freedom have featured prominently in British social and political history. They are widely regarded as a very positive aspect of British culture. However, the presumption of mental capacity and the privileged status of autonomy over the promotion of well-being may on some occasions result in unnecessary suffering and neglect. Currently, individuals are presumed able to make autonomous decisions about their treatment. Their autonomy can only be challenged through a proactive process, in which the health professional must provide valid arguments for overriding it.



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Beauchamp, T. L. and Childress, T. F. 1994. Principles of Biomedical Ethics, 4th edn. New York: Oxford University Press.
Gillon, R. 2003. Ethics needs principles – four can encompass the rest – and respect for autonomy should be “first among equals.Journal of Medical Ethics, 29, 307312. DOI: 10.1136/jme.29.5.307.


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