Patient autonomy in chronic care: solving a paradox.

Area of Science:

• Bioethics
• Medical Ethics
• Patient Autonomy

Background:

• The principle of autonomy is central to modern bioethics.
• Conflicts arise in chronic care between patient preferences and healthcare provider (HCP) focus on long-term health.
• Discrepancies exist between present-oriented patient desires and HCPs' preventative strategies.

Purpose of the Study:

• To demonstrate that patient autonomy is not always feasible.
• To explore how HCPs can act beneficently within autonomy principles without paternalism when patient autonomy is limited.
• To propose solutions by re-evaluating the concepts of the autonomous person, patient education, and trust in the patient-physician relationship.

Main Methods:

• Narrative review of bioethical principles.
• Analysis of the interplay between autonomy and beneficence in chronic care.
• Conceptual re-evaluation of patient autonomy, education, and trust.

Main Results:

• The exercise of patient autonomy is not consistently possible in all healthcare scenarios.
• A paradox emerges where beneficence may conflict with patient autonomy and respect.
• Ethical decision-making requires careful consideration of patient values and HCP responsibilities.

Conclusions:

• Revisiting the definitions of autonomous individuals and enhancing patient education are crucial.
• Building trust in the patient-physician relationship is essential for navigating ethical dilemmas.
• An ethical definition of patient education is provided to support clinical practice.