This principle could be argued to have equal moral weight with beneficence. In this scenario, therefore, the primary focus is not whether the patient directly benefits from the procedure but rather whether health care resources are distributed equitably. In this respect, it behooves managed care not physicians to act as guardians of social health care resources, alleviating physicians from the burden and difficulty of incorporating social and distributive issues at the bedside. Thus, managed care by setting guidelines and preserving resources is providing a service to this nation that physicians given the chance in the past failed to embrace. Thus, physicians can overrule patients' wishes.
Autonomy is more than freedom from outside restraint or freedom to make personal choices.
Many patients choose their health care packages. In accepting the benefits of the plans they elect, they are obligated to accept the limitations. Having exercised their autonomy they are bound to the consequences of their free actions, and in this respect, miscoding cannot be justified, since patients have accepted the limitations of their health coverage. Complex issues are rarely resolved by simple solutions. Today, more than ever, the medical profession grapples with the tension between patient care and health care costs.