Annotated Bibliography

A Patients Right to Autonomy

Melissa Tuttle
Professor Malcolm Campbell
English 1103
16 March 2016

Annotated Bibliography
Entwistle, Vikki A., Stacy M. Carter, Alan Cribb, and Kirsten McCaffery. Supporting Patient
Autonomy: The Importance of Clinician-patient Relationships. Journal of General
Internal Medicine. Springer-Verlag, 6 Mar. 2010. Web. 12 Mar. 2016.
The multiple authors of this academic source all have their PhDs, making them a reliable
source of information. The main point made in this article is the importance and value of
patient autonomy. It is suggested that many health care practices can disturb autonomy
due to personal beliefs or the practices beliefs as a whole. It can affect a patients choice
of treatment, but it can also affect a physicians character or their competence. The main
understanding is to help physicians identify how their actions and relationships with their
patients can allow or debilitate a patients right to autonomy. Respect for autonomy
includes, but does not limit to, confidentiality, honesty, and privacy. The authors state a
concern that the strong respect for autonomy could also lead to neglect. If a physician is
more apt to offer and allow an autonomous decision than to allow patients to make
knowledgeable choices, the bioethical principle may also fail to protect those who are
essentially capable but who struggle to choose between a course of treatment. This may
make the patient feel more neglected than autonomous. Another conflict with making
autonomous decisions is social influences. Our individual capability for autonomy is
socially shaped which can affect a personal decision. Being ill can affect an autonomous
choice by requiring a change of life or personal plans. This can impair a patients
decision as they cannot see the whole picture clearly. This article encourages physicians
to tend to the patients life plans and their capability of making an informed decision.
The authors views are mostly objective. The authors covered the roadblocks they may

come across in making sure a patient is making a knowledgeable decision. All of the
authors have their PhD, making them a reliable source. The information presented in this
academic source is supported by research from their respected universities. The intended
audience was the conference held at the University of Stirling in September of 2009.
This source brings up the point of patient competence in making an autonomous decision.
This was very helpful in learning how patient competence can affect a personal choice of
treatment.
Pantilat, Steve. "Autonomy vs. Beneficence." UCSF School of Medicine. N.p., 2008. Web. 12
Mar. 2016.
The author, Steve Pantilat, has his MD and is an Associate Professor of Medicine at the
UCSF School of Medicine. Pantilat evaluates the relationship between autonomy and
beneficence. On this academic webpage, Pantilat applies real life actions/behaviors with
two very important principles of bioethics that can conflict when treating a patient.
Ethical issues may arise when the patients autonomous choice conflicts with the
physicians beneficent obligation. Autonomy is the personal rule of the self that is free
from both controlling interferences by others and from personal limitations that prevent
meaningful choice. The obligation of a physician is to help the patient make an
autonomous choice. Physicians need to respect the patients choice, whether the
physician agrees with the choice or not. People go to the doctor to get more information
as to what is going on with their body, so the physicians ultimate job is to inform and
educate the patient. A subsection of autonomy is providing confidentiality and privacy
for the patient. An example of an autonomous action would be presenting the patient
with every option, set of treatments, or risks that may go along with their course of

treatment. Beneficence is doing something that will benefit someone else. A beneficent
act can be taken to prevent further damage or harm. The main goal when treating a
patient is to promote their well-being. Physicians are well educated and trained to aid in
assisting others. Doctors have two main obligations: to prevent/remove harm and
weigh/balance the benefits and risks for a personalized course of treatment. A subsection
of beneficence is to protect and defend the patients rights, rescuing a person in danger,
and helping an individual with a disability. An example of a beneficent action would be
encouraging a patient to quit smoking and lead a healthier lifestyle. In conclusion, the
physician should respect the patients decision as long as the patient understands the
risks/benefits. The authors view is objective. The author covered the relationship
between autonomy and beneficence and how they can conflict when treating a patient.
Having an MD and being an Associate Professor of Medicine deems him a reliable source.
The information presented in this academic source is supported by medical ethics and
principles. The intended audience are the students of UCSFs School of Medicine and the
general public who are interested in this topic. This source compares autonomy to
another bioethical principle, unlike my other sources. This source was very helpful in
getting the importance of patient autonomy across. This fits into my research because it
directly correlates to my topic.
Respect: Dignity, Autonomy, and Relationships-Ethical Issues in Nursing. Films On Demand.
Films Media Group, 2006. Web. 12 Mar. 2016.
This academic program gives commentary from healthcare professionals. Real life
scenarios are incorporated in this video, giving it a more personal and visual aspect. This
video familiarized me with the general concept of respect for a patient no matter the race,

religion, socio-economic status, etc. The video explores the importance of establishing
positive relationships with patients, offering practical ways that nurses can show respect,
and emphasizing human dignity in their work. The program clearly describes the nurses
role in supporting patient autonomy, informed consent, and the practice of extending
respect beyond patients to ones colleagues as well. Because we are human, it is
sometimes hard to decide how to provide care to patients. A physician is to practice with
respect and compassion for the inherent dignity, worth, and uniqueness of every
individual that is unrestricted by the patients social or economic status, personal
attributes, or the nature of health problems. Basic respect for human dignity can even
come through small gestures from helping them make a phone call to helping them make
an informed decision. Giving a patient the right to an autonomous decision is a moral
and legal right. Autonomy allows the physician to educate patient, but not to make their
decision for them. It is an ethical mandate. If a patient is not competent, a legal
surrogate can make a decision for the patient. The authors view is objective. The author
covered general concept of respect for a patient. The information presented in this
academic source is supported by the American Nurses Association Code of Ethics. The
intended audience is for anyone who wishes to view this video. This video was very
helpful in learning how to respect and create positive relationships with patients. This fits
very well in my research by proving the importance of dignity and right to autonomy for
a patient.
Weston, M.J., Strategies for Enhancing Autonomy and Control Over Nursing Practice OJIN:
The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 2. Web. 31 Jan. 2010.
Maria Weston, author of this scholarly article, has her PhD and RN license. She is also

the Chief Executive Officer of the American Nurses Association and the American
Nurses Foundation. This makes her a very reliable source of information. This article
outlines ways to improve autonomy among colleagues. Having control over nurse
autonomy creates a healthier work environment. This improves nurse satisfaction and the
quality of patient results. Patient autonomy is just a subset of autonomy. Employee
autonomy has been associated with improved outcomes as well. Nurse education and
hospitals with better care environments (nurse autonomy and control over nursing
practice) were found to be correlated with significantly lower mortality rates. A more
positive relationship between colleagues has been shown to aid in decision making and
all over performance. Nurses can improve autonomy by communicating and organizing
their work to make sure that they have the ability to act on nursing decisions using logical
clinical reasoning. Promoting autonomous actions and examining them can help the
physician to reflect on their decision making in order to better their practices. Teaching,
coaching, and supporting physicians will promote a better environment for increasing
autonomy. Medical practice impacts patient outcomes. Autonomy among employees
enriches the medical profession and quality of patient care. The authors view is
objective. Her practice and research have been focused on autonomy and control over
nursing practices. The author covered what is needed to enhance autonomy and nursing
practices. The information presented in this scholarly source is supported by research
and hands on practice. This article covers autonomy between colleagues and not strictly
patient autonomy, changing the point of view. This fits into my research, but I do not
think it fully supports the concept of my topic.
Comments Taylor Huffman

Personally I had some difficulty following what was being said at some points,
maybe including a simpler definition of things or explaining what some things

mean after a sentence would be helpful

I think that coming out and giving a simplified definition of autonomy would be

helpful
I think your sources are highly reliable and useful
I liked how your information was very objective and how you went into depth

with it, I think that there is a lot here that will be well placed in your EIP
Overall I think you did a really good job on this piece, I just think that
somethings should be simplified or at least a simplified definition should be
offered as some times things got a little wordy.