Читать книгу Becoming a Reflective Practitioner - Группа авторов - Страница 81

Autonomy is the person’s right to be self‐determining. Seedhouse (1988) views autonomy as the highest ethical principle. In respecting a person, the practitioner actively involves that person in decision‐making about their healthcare as much as possible. In past days, professional autonomy was universally accepted in a capitalist construction of healthcare whereby the patient gave up his rights in return for healthcare (Parsons 1951). Now the situation is very different, although a tension may exist between professional and patient autonomy as to who has the legitimate authority to make decisions.

Without a doubt, people are more informed about their health. Just ‘Google’ any health condition to reveal an overload of information, challenging the idea that professional knowledge is beyond the public’s general understanding. Hence the practitioner’s role shifts from doing things to, at or for patients, to working with them as far as they are able. However, for whatever reason, many people may be passive. As such, the practitioner should act in the person’s best interests.

Acting on behalf of others is termed ‘paternalism’. Benjamin and Curtis (1986) set out three criteria to legitimate such action:

 Harm – would the patient come to some harm if I hadn’t act for them?

 Autonomy – is the patient able to act for themselves?

 Ratification – would the patient at a later time thank me for my actions?

Yet how easy is it to advocate for patients rather than respect their autonomy on the premise that we are the health professionals and we know what’s best for the patient. The risk is that the patient becomes an object we do things to. We do not see the patient just what needs doing to them.