Patient's autonomy vs doctor's professional integrity.
In recent years, there exists a world-wide tendency to stress patient's autonomy instead of doctor's paternalism in daily medical practice. This tendency must be appreciated as "every human being of adult years and sound mind has a right to determine what shall be done with his own body". But this autonomy sometimes conflicts with the doctor's personal integrity which is essentially a pro-life one. In some western countries, this autonomy is legally admitted even in life-shortening procedures such as an abortion or euthanasia in the terminally ill patients. In 1994 a Japanese scientific council made a report concerning "death with dignity" and declared that the withdrawal of foods from PVS patients should be proceeded under his or his supposed will, and in a criminal case decision in 1995, criteria for the active euthanasia in the terminal patients are proposed. In both situations, the actor should be a doctor. These life-shortening procedures might be appreciated for the autonomy of patient and be legally permitted. But conscientious refusal of doctor against proceeding these acts must be also admitted, as the philosophy of each doctor about the sanctity of terminal life is different from doctor to doctor as in lay persons.
Dept. Neurosurgery, Kantoh Central Hospital, Tokyo, Japan.
Y
Y
Tsukamoto
D000328:Adult; D001803:Blood Transfusion; D004992:Ethics, Medical; D005065:Euthanasia / Q000331:legislation & jurisprudence; D005260:Female; D005610:Freedom; D006801:Humans; D007258:Informed Consent; D007564:Japan; D008297:Male; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D014481:United States