Furthermore, they apparently view patient autonomy in therapeutic decision making as inviolable. Values-based decision making is especially integral to the role of physician and cannot be exclusively delegated to patients or their surrogates. If patients were granted total autonomy, physicians would become mere technicians whose sole purpose would be to dispense medical treatment, which is not necessarily the same as providing medical care. Thus, it seems to me that patients and physicians need to respect each other s autonomy if they are to achieve a proper balance that takes into account the values and goals of both parties and the expected outcomes of medical care and treatment. All patients must be treated as an individual, which means that their goals and cultural and religious beliefs must be identified and taken into account during therapeutic decision making.
Patients have the right to refuse treatment.
In other words, patient autonomy is not an absolute and physicians cannot be compelled to violate their own professional integrity, ethical values, and moral beliefs. Since therapeutic outcome cannot be predicted with absolute certainty, physicians, patients, and family members may well disagree about whether a given treatment is futile. Their perceptions of the goal of treatment may differ as well. These differences, which are exacerbated by poor communication, are the most common cause of conflict. To help avoid or resolve conflict, physicians must start by attending to patients and surrogates values, goals, and concerns.