Avtor/Urednik		Zwitter, Matjaž
Naslov		Etično načelo spoštovanja avtonomije in njegove omejitve
Prevedeni naslov		Ethical principle of respect for autonomy and its limitations
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 37, št. 1
Leto izdaje		1998
Obseg		str. 101-15
Jezik		slo
Abstrakt		Respect for autonomy - one of the four basic ethical principles - is based on the right for self-determination. An autonomous individual should be offered all relevant information so that he/she can understand the consequences of various options, make free choices and implement his/her own decisions. Thus, respecting one's autonomy involves assuming several obligations, including the obligation to assure another person an optimal degree of autonomous decision-making. Based on the principle of autonomy are also the right for protection of personal data. Limiting one's autonomy should be understood as a stepwise, rather than abrupt all-or-nothing way of restricting one's right to self determination. Limitations of autonomy are categorised as follows: voluntary limitations, implying that a person wishes to transfer the right to decision-making to another person; enforced limitations which are either justified, i. e. enforced as an inevitable consequence of adjusting the conflicting interests of individuals and society, or unjustified, resulting from restricted information, or from pressures hindering free decision-making and, inevitable limitations of autonomy due to one's incapacity to make free decisions. In the later case, we have to rely on advance directives or surrogate decision-making. In advance directives, the crucial question is whether at the time when the statement the person was fully aware of his/her future position, future (not actual) preferences, and implications his/her decisions. Respect for autonomy, however, should not be the guiding principle in surrogate decision-making; rather, the decision should rely on the principles of beneficence, non-maleficence and justice.
Izvleček		Spoštovanje avtonomije posameznika, eno od štirih osnovnih etičnih načel, izhaja iz pravice, da vsakdo samostojno odloča o sebi. Med pravicami, ki izhajajo iz tega etičnega načela, sta tudi pravici do zasebnosti in do varovanja osebnih podatkov, ki bi ju bilo mogoče zlorabiti proti interesom osebe in s tem omejiti njeno avtonomijo. Pri omejitvah avtonomije je pomembno, da jih razumemo kot stopenjsko, ne pa vse-ali-nič omejevanje pravice odločanja. Omejitve avtonomije lahko razvrstimo v tri skupine: na prostovoljno omejitev, vsiljene omejitve in na neizbežno omejitev avtonomije, ko zaradi mladosti ali bolezenskega stanja oseba ni sposobna za polno avtonomno odločanje. Kadar posameznik ob času odločitve ni sposoben avtonomnega odločanja, se ravnamo po vnaprejšnjem ali pa po nadomestnem odločanju. Pri veljavnosti vnaprejšnjega odločanja je ključno vprašanje, ali si je oseba tedaj, ko je še bila sposobna avtonomnega odločanja in je sporočila svojo voljo za primer bodoče nesamostojnosti, resnično predstavljala vse okoliščine svojega bodočega položaja. Pri nadomestnem odločanju pa je bistveno spoznanje, da se to ne sme naslanjati na načelo spoštovanja avtonomije, pač pa na etična načela dobrodelnosti, neškodovanja in pravičnosti.
Deskriptorji		ETHICS, MEDICAL HUMAN RIGHTS INFORMED CONSENT PATIENT ADVOCACY