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The manner in which a patient is handled may undermine or support the autonomy of a patient and for this reason, the way a patient is communicated to becomes very crucial. A good relationship between a patient and a health care practitioner needs to be well defined to ensure that autonomy of a patient is respected. [39]
Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient and their family rather than medical professionals. [22] The increasing importance of autonomy can be seen as a social reaction against the "paternalistic" tradition within healthcare.
However, in withholding information, there is also a denial of patient autonomy [3] Therapeutic privilege is an exception to the general rule of informed consent, and only applies when disclosure of the information itself could pose serious and immediate harm to the patient, such as prompting suicidal behavior. [4]
A suggested way to maintain autonomy is for the person to write an advance directive, outlining how they wish to be treated in the event of their inability to make an informed choice, thus avoiding unwarranted paternalism. Another theme is confidentiality and this is an important principle in many nursing ethical codes.
A patient's bill of rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a patient's bill of rights guarantees patients information, fair treatment, and autonomy over medical decisions, among other rights.
Patient advocacy, as a hospital-based practice, grew out of this patient rights movement: patient advocates (often called patient representatives) were needed to protect and enhance the rights of patients at a time when hospital stays were long and acute conditions—heart disease, stroke and cancer—contributed to the boom in hospital growth.
Patient Autonomy and the Ethics of Responsibility, Cambridge: The MIT Press, 2005. Henry David Thoreau and the Moral Agency of Knowing. Berkeley and Los Angeles: University of California Press, 2001. (Paperback 2003) Confessions of a Medicine Man: An Essay in Popular Philosophy Cambridge: The MIT Press, A Bradford Book, 1999 (Paperback 2000 ...
Examples include, clinicians discussing treatment options with one another prior to talking to patients or their family to present a united front limited patient autonomy, hiding uncertainty amongst clinicians. Decisions about overarching goals of treatment were reframed as technical matters excluding patients and their families.