What is the Scope of Autonomy in Medical Practice?

Autonomy, literally meaning self-rule, is an essential ethical principle, especially within the field of medicine. An individual with autonomy can make decisions on the basis of reflection and deliberation [1]. In general philosophy, autonomy is thought of as “the ability to be one's own person, to live life according to rationale and purpose that are taken as one's own and not the consequence of controlling or distorting outside forces” [2]. Individual autonomy is a notion that cultivates both self-ownership and self-governance and is based on ‘respect for persons‘, which states that all persons have the right “to make their own choices and develop their own life plans” [3]. The scope of autonomy reflects how farreaching autonomy is, and what its boundaries are. This paper analyses the scope of autonomy in order to achieve greater clarity, and asks if this ethical principle should be superior to the three other principles (beneficence, non-maleficence and justice) rather than just “prima facie”.[4] Indeed, if there were to be a single overriding principle at all, should it definitely be autonomy rather than any of the other three? These questions will be dealt with and explored with the aid of medical ethical scenarios which help illustrate the points raised. We will identify what the limitations of autonomy are, and how far-reaching it is, all within the medical context.