Patient Autonomy CASES

In English medical law, patient autonomy is the principle that a person with capacity is entitled to make their own decisions about medical treatment, including refusing treatment, even where others consider the decision unwise.

Definition and principles

Patient autonomy reflects respect for personal dignity and self-determination. It requires clinicians to involve patients in decisions affecting their bodies and health and to respect the choices they make.

Autonomy is closely linked to the law on consent. Treatment given without valid consent may be unlawful, and may give rise to claims in negligence and, in some situations, battery.

Informed consent

For autonomy to be meaningful, consent must be informed. Clinicians must take reasonable care to ensure the patient is aware of material risks of proposed treatment and of reasonable alternatives, including the option of no treatment, where relevant.

Capacity and decision-making

Autonomy depends on capacity. Where an adult lacks capacity, decisions must be made in their best interests under the Mental Capacity Act 2005, taking account of their wishes, feelings, values, and beliefs. Capacity may fluctuate and must be assessed in relation to the specific decision at the time it is needed.

Limits and practical application

Autonomy is not absolute in every situation. For example, urgent treatment may be provided where a patient lacks capacity and delay would cause serious harm. However, where a patient with capacity refuses treatment, including life-sustaining treatment, that refusal should ordinarily be respected.

Practical importance

Understanding patient autonomy helps clinicians communicate risks and options properly and supports lawful, patient-centred care, reducing disputes and complaints.