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Law and MedicineCurrent Legal Issues Volume 3$
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Michael Freeman and Andrew Lewis

Print publication date: 2000

Print ISBN-13: 9780198299189

Published to Oxford Scholarship Online: March 2012

DOI: 10.1093/acprof:oso/9780198299189.001.0001

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Legal Limits: When does Autonomy in Health Care Prevail?

Legal Limits: When does Autonomy in Health Care Prevail?

Chapter:
(p.141) Legal Limits: When does Autonomy in Health Care Prevail?
Source:
Law and Medicine
Author(s):

Anne Flamme

Heidi Forster

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780198299189.003.0008

In an attempt to locate the boundary between individual autonomy and the state’s power to intervene in health-care decision-making, this chapter describes how particular courts understand or depict autonomy in the context of health-care decision-making; the state interests courts recognize that conflict with autonomy; and the analyses courts use to reconcile these interests. It reviews United States statutory and common law doctrines governing four different health-care decisions: organ donation, refusal of life-sustaining treatment, abortion, and physician-assisted suicide. The review of the judicial balancing of individual autonomy against state interests illuminates two concepts of autonomy in health-care decision-making. The first is a physical one, grounded in the notion of bodily integrity and freedom from invasion of one’s physical being. The second is a more abstract concept of self-determination, encompassing the liberty to define meaning for oneself and control one’s destiny and finding legal protection in the doctrine of substantive due process. It is argued that courts are consistently willing to protect the concept of autonomy grounded in bodily integrity, but are not willing to protect a broader right of non-interference in all personal and intimate decisions. While courts generally will not interfere in individuals’ thoughts, values, and beliefs about the quality of their life or their reasons for making their personal choices, courts will place limits on the actualization of those beliefs.

Keywords:   individual autonomy, health care decision-making, state interest, organ donation, abortion, physician-assisted suicide

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