In considering the concept of patients'right to autonomy, this paper first reviews the alignment between autonomy and personal responsibility and the interrelation between autonomy and personal rights. It then investigates the guarantees and
obstacles of the Patient Right to Autonomy Act which safeguards patient autonomy. This is followed with a discussion of the potential ethical controversy which implementation of this Act entails.
Due to tremendous advances in health care, patients living with terminal illness or occupying persistent vegetative states may undergo severe pain induced by what some may regard as overtreatment. As a result, considerations around patient autonomy arise with increasing frequency and gravity, to the point that they have become a regular topic in discussions of medical ethics.
According to the Buddhist view of Dependent Origination, patient autonomy is a relative rather than an absolute freedom of choice due to two significant components of the medical decision-making process—uncertainty and lack of agency. Regarding uncertainty, patients may not be able to consciously address changes to their autonomous wishes (or advance medical directive) once their illness reaches a more advanced stage. As for agency, there are times when, even though their wishes are carried out, patients are unable to receive immediate assistance in dying to end their pain and suffering. Thanks to the Patient Right to Autonomy Act, patients are relieved of the plight presented by being unable to make personal medical choices once they are no longer
capable of exercising either conscious deliberation or agency.
Fear of death and avoidance of suffering are two strong instincts of life. At times, sharp pain may seem even more unbearable than death.However, the internal strength which arises from practices generating boundless loving-kindness may also encourage individuals with deteriorating health to overcome their fear of suffering and develop the resolve to continue to “do their best to live”.
In sum, there is no fixed conclusion regarding patient autonomy. Rather, it often varies due to patients’ health conditions, the support they receive, or changes in external circumstances. For these reasons, questions around patient autonomy are often an exploration from within the soul, and characterized by fluidity and subtlety.