“Misapplying Autonomy: Why Patient Wishes Cannot Settle Treatment Decisions” is the title of a forthcoming paper in Theoretical Medicine and Bioethics co-authored by Colin Goodman and Timothy Houk, PhD. Goodman is a fourth-year medical student who is also a member of the Medical Humanities Scholarly Concentration, and Houk is a former postdoctoral fellow of the McGovern Center who now is Associate Professor of Philosophy at College of the Sequoias.
The principle of autonomy is widely recognized to be of utmost importance in bioethics, but we argue that this principle is often misapplied when we fail to distinguish two different contexts in medicine. When a particular patient is offered treatment options, she has the ultimate say in whether to proceed with any of those treatments. However, when deciding whether a particular intervention should be regarded as a form of medical treatment in the first place, it is the medical community who has the ultimate say. Some argue that particular interventions should be allowed in virtue of the fact that they are autonomously requested. But making such an argument fails to distinguish between these two contexts and misapplies the principle of autonomy, and this could lead to a problematic change in the practice of medicine.