Privacy Informed Consent and Paternalism

Autonomy as a fundamental right is used to justify rights to privacy, confidentiality, refusal of treatment, informed consent, and a decent minimum of healthcare. The legal right to privacy has two components. The right to control information about oneself is protected in medicine as the patient's right to confidentiality of information gained by health professionals. The right not to be interfered with and to make one's own decisions is protected in medicine as a competent patient's right to refuse recommended treatment and as the obligation of health professionals to obtain a patient's informed consent to treatment. Informed consent requires that a patient be informed of a recommended treatment and of the options for treatment and their likely consequences, and that the patient give express permission for a treatment (often in writing). The right to autonomy also requires that patients be told the truth about their medical status and prognosis, that their questions be answered, and that they receive assistance from healthcare providers in making rational decisions. Meaningful exercise of the right to autonomy in living requires that individuals possess physical and psychological capacities within the normal, human range. So the positive right to autonomy supports a right to a level of healthcare that will return and maintain a person to the normal range of functioning. This includes acute care, for example, repair of a broken bone; chronic care, for example, treatment of diabetes or heart disease; and supportive care for permanent disability, for example, wheelchairs for paraplegics.

Paternalism in healthcare is treating a patient against his or her wishes on the grounds that the healthcare provider is professionally obligated to provide care that will benefit patients, and that the healthcare provider knows better than the patient what is good for the patient. When paternalism is justified, it overrides patient autonomy, at least partially. An example of justified paternalism could be when a physician does not accede to a patient's refusal of emergency treatment because the patient believes he or she will surely die.

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