Now she is in the hospital, and someone else is here to take more blood. She is told she must have a transfusion and take more chemo. Nothing until then. In medicine, autonomy has changed dramatically over the last 50 years. Autonomy has become the most important ethical principle in modern medicine, more than beneficence, integrity, justice or respect for the person.
Physicians sometimes have to fight hard to do what they think is best in a patient's case.
Yet without more respect for patients' ability to make their own choices, physicians will cede not only their clinical authority to regulators and politicians, but also their basic livelihoods to business people, some of whom are bandits. And bandits have already stolen issues on which physicians should be leaders. Relief of pain and suffering near the end of life is one issue for physician leadership. Every physician can prevent the invasion of last-moment medical technology that serves to delay a patient's death only briefly. Every physician can recognize that a devastating stroke, not a decision to honor a family's request to discontinue a mechanical ventilator, is the cause of that patient's death.