Book contents
- Frontmatter
- Contents
- Part 1 THE EXTREMELY PRETERM INFANT: EPIDEMIOLOGY, PERCEPTIONS, AND PRACTICES
- Part 2 BIOETHICS
- 14 Moral Theory
- 15 Autonomy
- 16 Beneficence and Nonmaleficence
- 17 Justice
- 18 Sanctity of Life
- 19 Active and Passive Euthanasia
- 20 Personhood
- 21 Quality of Life and Best Interests
- 22 Futility
- Part 3 REPORTS, OFFICIAL OPINIONS, AND GUIDELINES
- Part 4 THE LAW
- Part 5 EPILOGUE: TRUTH, TRUST, AND BOUNDARIES
- References
- Index
15 - Autonomy
Published online by Cambridge University Press: 23 September 2009
- Frontmatter
- Contents
- Part 1 THE EXTREMELY PRETERM INFANT: EPIDEMIOLOGY, PERCEPTIONS, AND PRACTICES
- Part 2 BIOETHICS
- 14 Moral Theory
- 15 Autonomy
- 16 Beneficence and Nonmaleficence
- 17 Justice
- 18 Sanctity of Life
- 19 Active and Passive Euthanasia
- 20 Personhood
- 21 Quality of Life and Best Interests
- 22 Futility
- Part 3 REPORTS, OFFICIAL OPINIONS, AND GUIDELINES
- Part 4 THE LAW
- Part 5 EPILOGUE: TRUTH, TRUST, AND BOUNDARIES
- References
- Index
Summary
An important principle in bioethics is respect for autonomy. Clearly, extremely preterm infants do not have autonomy, and surrogates, usually parents, are granted the right to make decisions for them, on the basis of a special relationship. This is not without limits, and where consent to treatment is concerned they have a duty to act in the best interests of the child, from the perspective of the child. Determining this may be difficult. Correct respect for autonomy demands that parents are given ample opportunity to express their views and that these are heard and addressed in a considerate manner. Physicians have a duty to recognize and protect the future of the child, who is both vulnerable and without autonomy.(184) Babies, of any gestation, require the protection of parents, health professionals, and society and have a moral and legal right to receive this protection. Other physicians' duties, which relate directly to the health-related interests of the baby, include the correct exercise of knowledge and expertise; the acknowledgment of any lack of knowledge; and a requirement to seek knowledge and guidance, not to provide ineffectual treatment, to respect the law, and to provide alternative care when required. The duty of physicians, and their perceptions of these, when they are centered on the infant, may conflict with parental wishes and lead to severe emotional and economic family burden and threaten its very integrity. Conflict may arise that leads to intervention by ethics committees, and sometimes the courts, which in itself may further division.
- Type
- Chapter
- Information
- Extreme PrematurityPractices, Bioethics and the Law, pp. 59 - 61Publisher: Cambridge University PressPrint publication year: 2006