ABSTRACT
The concept of patient autonomy itself is not a ‘new’ concept in health care. Indeed it is one that health care practitioners have considered throughout the development of the health services. It is generally considered that a major goal of health care is the restoration of autonomy in individuals who for varying reasons may have their autonomy compromised or diminished. A lack of information, lack of understanding about one’s circumstances, inability to make rational choices due to disease or illness and lack of power to act on the choices made, are all contributing factors to the patient autonomy debate (Norman, 1993; Oddi, 1994; Seedhouse, 1988). Yet, even in situations where the patient is reliant on the health care practitioner, it is often argued that if people are considered to be autonomous, then this autonomy should be respected (Seedhouse, 1988). The challenges and conflicts in operationalising this principle, are evident in the literature (for example Scoccia, 1990; Pollard, 1993; Ridley, 1989; Abramson, 1990; Langslow, 1992). For some commentators, the centralising of the concept of autonomy in health care practice merely reduces the practitioner’s role to that of ‘servant of the patient’ (McKinstry, 1992). While for others (Fulford, 1996; Hope, 1992; Agich, 1993; Judge, 1996) such a position makes explicit the role of the professional in the context of patient decision making.
