ethical issue - Autonomy - basic concepts

Autonomy. - what is this?

in understanding patient's autonomy, we need to define what exactly is autonomy first.

according to Dorland's, autonomy - the state of functioning independantly, without extraneous influence.

hence it basically means that the patient has the right to choose what it is done to themselves.

it is the opposite of this thing called Paternalism - where the doctor chooses what to do to the patient without listening to patient's opinions. this was somewhat a traditional approach, but as people are more informed nowadays, things have been changing.

now the trend seems to be "informed consent", where the doctor..

1. sets out a treatment option, 
2. explains what it involves, its risks etc etc
3. patient says if its okay to proceed
4. treatment is done.

and there is this new thing called Shared Decision Making (SDM) where there is a heavier emphasis on autonomy, where

1. patient is presented with SEVERAL treatment plans by the doc - sometimes patient suggests some treatment plans too
2. both parties discuss what is best for the patient - taking into consideration evidence- based facts, psychological factors and social factors as well.
3. when both parties can agree on a treatment, treatment proceeds.