Autonomy as a universal expectation: a review and a research proposal.

Catedra de Bioetica, Escuela de Medicina, Universidad nacional del Comahue, Catamarca 140, (8324) Cipolletti, Rio Negro, Argentina.
Eubios journal of Asian and international bioethics: EJAIB 04/2003; 13(2):53-7.
Source: PubMed

ABSTRACT In the World Health Report 2000 WHO introduces ethical issues in the elevation of health systems responsiveness performance. Although we consider this a positive step, the parameters considered in the Report are in some cases unsustained by extensive research. This is the case of autonomy, which is postulated as a "universal expectation". As we think that this is culture-linked issue we argue that such kind of universal categorizations lacks substantive empirical evidence. We undertook a short review of a small intentional sample of international literature, in order to demonstrate that regardless of the philosophical status of autonomy as a principle or category there is not background enough to postulate it as a universal expectation. We propose international collaborative research to define the issue, using qualitative research methodology.

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    Dataset: EJAIB12012
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    ABSTRACT: Abstract Background: In the technologically underdeveloped society, it is a common belief that patients are not aware of their rights and duties. The theory of paternalism dictated the medicine man and still continues to do so in third world, developing nations. Objective: To assess the awareness and knowledge regarding patient’s rights and duties, of upper and middle socioeconomic classes, living in a cosmopolitan city of Karachi, Pakistan. Methodology: After institutional permission, a 10- questions survey instrument was designed and tested. Data was collected at a public awareness program open for all residents of Karachi. Autonomy, beneficence, confidentiality, ‘do no harm’ and equality were considered as the patient’s rights. ‘Doctor-shopping’, non compliance with physician advice, hiding information from ones’ physician and asking for medical coverage were among the patient’s duties. Descriptive analysis and scoring was done using SPSSv.16. Results: Out of the total of 269, 200 (74%) knew that they have right over their doctor’s decision. Most 211 (78%) assumed their physicians did not share their information with others. Many, 167 (62%) thought that their doctor do not give favor to others over them. Just 18 (7%) reported non-compliance, while 102 (38%) revealed that they did consult and followed medications of two physicians for the same disease, simultaneously. Few, 19 (7%) hide important information from their physician. Conclusion: Contrary to the belief, our people from upper and middle socioeconomic classes are aware of their rights and duties as patients. However, the level of awareness and knowledge needs improvement.
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    Eubios journal of Asian and international bioethics: EJAIB 01/2012; 22(1):43-6.