Legal aspects of clinical autonomy

Clinical autonomy has become a subject of discussion and revision because of a number of developments. In hospitals, doctors are ceasing to function as independent entrepreneurs and see their autonomy curtailed by organizational constraints and imperatives. More important however is the growing interference of public authorities who seek to promote equity and social justice within a framework of scarce resources. Professional standards are also a force which is limiting clinical freedom. Finally, the autonomy of physicians is revisited, because of the growing assertiveness of patients, who want to participate in the decisions regarding their own medical care.