The principle of autonomy and its particularities in the local community

Abstract

Introduction. Bioethical literature describes the patient’s autonomy as his capacity and authority to decide freely in accordance with a self-chosen plan while realizing the impact of its own actions and without being influenced in his decisions. These traits of autonomy become premises for analysis and debate for many contexts in medical community. Also, this subject includes current interpretations, as a great number of patients still tolerate paternalistic approaches, either out of indifference or health culture. Aim of the study. The purpose of the study consist in highlight from a theoretical point of view some bioethical particularities which express the context of implementation of the autonomy principle in the local community. Materials and methods. For this study it was necessary to select materials from various books, articles and collections on bioethics, medicine and law, statistical data obtained from official sources. The work was structured and rendered by the method of analysis, comparative method, statistical and hermeneutic method. Results. Recent statistical reports on the health system indicate that only 71% of patients undergoing surgery have confirmed that they have signed the informed consent form. At the same time, the majority of respondents confirmed that they were sufficiently informed about planned medical interventions and risks, the percentage of which was higher in republican hospitals (79.1%) than in district hospitals (70.4%). Similarly, 25.5% of respondents announced that they had been insufficiently informed or they had not been informed at all. These data confirm a lack of communication between healthcare professionals and patients. More than 1/4 of patients neglect the right to the principle of autonomy by not signing the informed consent form. These data reflect certain differences between what we call a bioethics requirement and the legal framework in the realization of the medical profession and the social realities. Lack of informed consent also suggests certain deficiencies about the patient's health culture. It can also be observed that the absence of the patient's autonomy is also determined by the patient's position towards his life and health. Conclusions. Some criteria that could promote the principle of autonomy consist in: 1) the development of health education within children's and youth communities; 2) the extension of health education in urban and rural communities; 3) supporting campaigns to promote health rights.