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Medicine, Health Care and Philosophy

, Volume 4, Issue 1, pp 71–77 | Cite as

Patient autonomy in emergency medicine

  • Anne-Cathrine Naess
  • Reidun Foerde
  • Petter Andreas Steen
Article

Abstract

Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different genuine efforts the physician can do to uncover treatment refusal and respect patient autonomy in an emergency situation. Autonomy requires competence and in emergency medicine time does not allow intimate exploration of patient competence and reasons for treatment refusal. We find that the physician must base her decision on a firm theoretical base combined with a practical and realistic view of the patient's situation on a case to case basis.

ethics mental competence physician integrity physician-patient relationship respect for autonomy treatment refusal 

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Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Anne-Cathrine Naess
    • 1
  • Reidun Foerde
    • 1
  • Petter Andreas Steen
    • 2
  1. 1.Centre for Medical Ethics, School of MedicineUniversity of OsloOsloNorway
  2. 2.Division of SurgeryUlleval University Hospital and University of OsloOsloNorway

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