Ethics Glossary

Autonomy (Patient)

Latin root meaning is ‘self-rule’ or ‘self-law’.  ‘Autonomy’ is often used interchangeably with ‘self-determination’.  Associated with ‘emancipated’ to differentiate a sub-set of minors from the default that parents are minors’ surrogate decision-makers.  To be autonomous is to be sufficiently free to reach one’s own conclusions about what ought to be done.  An autonomous person is sufficiently free from controlling interferences and from limitations (e.g., access to information) to exercise responsible decision-making and to be responsible for outcomes.  Patients with decisional capacity have the right to participate in decisions about the life-sustaining treatments they receive, especially by clearly conveying to the care team their goals of care and their values. They have the right to be informed of their diagnosis and their prognosis, to be involved in their care planning and treatment, and to request or refuse treatment.  They have the right to refuse or to discontinue any treatment even if doing so will cause injury or hasten death.  However, as per CMS Standard 482.13(b)(2), pp. 66-67, “this right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate”.  They do not have the right to expect/demand any treatment.