[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [Foundations of bioethics](https://durgical.com/en/medical-ethics/areas/foundations/) › Respect for autonomy # Respect for autonomy - Principle A capable, informed person has the right to decide about their own body and treatment, even when the doctor disagrees. Updated Nov 5, 2026 ## Key points - Conditions of an autonomous decision: capacity, enough information, understanding and voluntariness (no coercion). - A capable patient may refuse any treatment, even a life-saving one. - Capacity is assessed for each specific decision; a psychiatric diagnosis does not remove it by itself. - Exceptions to consent: life-threatening emergency, incapacity (the surrogate decides), the patient's waiver and, with great caution, therapeutic privilege. - In Colombia, Law 23 of 1981 requires consent for treatments that may affect the patient (art. 15). ## What it is Respecting autonomy means recognising that a capable adult decides about their own life and health according to their own values. A decision is autonomous when the person understands the information, acts intentionally and is free of coercion. The principle has a negative side (do not impose treatment or manipulate) and a positive side (inform truthfully and support the person in deciding). It underpins informed consent, the right to refuse treatment and confidentiality. ## What it requires - Inform truthfully, in plain language, about the diagnosis, the options, their risks and the option of no treatment. - Check that the person understands and can reason about the information. - Make sure they decide without coercion, manipulation or undue pressure from family or staff. - Accept the decision of a capable person even if the doctor thinks it is wrong. - Protect their privacy: what the patient tells belongs to the patient. ## In clinical practice - Refusal of treatment: explain the consequences, record it in the medical record and keep offering the care the person accepts. - Patient unable to decide: look for their earlier wishes (advance directive) and let the surrogate decide according to them. - Cultural differences: some people prefer to decide with their family; respecting autonomy includes respecting that choice if it is free. - Autonomy does not oblige the doctor to give treatments without an indication: the patient chooses among reasonable options. ## Limits and exceptions - Emergency: if there is no time or way to obtain consent, act to save life (Law 23 of 1981, arts. 14 and 15). - Waiver: the person may ask not to be informed and delegate the decision. - Therapeutic privilege: withholding information is discussed only when telling would cause serious, immediate harm; it is a narrow and much-criticised exception. - Public health: some measures (quarantine, mandatory reporting) limit autonomy to protect others. ## Test yourself Think of the answer, then tap the question to see it. ## Which four conditions make a decision autonomous? Capacity, enough information, understanding and voluntariness (no coercion). ## May a capable patient refuse a treatment that would save their life? Yes. If they are capable, informed and decide freely, the refusal is respected; it is recorded and other care keeps being offered. ## Which exceptions allow acting without consent? A life-threatening emergency with no way to ask, incapacity (the surrogate decides), the patient's waiver and, very narrowly, therapeutic privilege. ## Which article of Colombia's Law 23 of 1981 requires asking for the patient's consent? Article 15: the doctor will ask consent for the treatments considered necessary that may affect the patient, except when this is not possible. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/medical-ethics/respect-for-autonomy/) ## Connections ## Related 2 - [Informed consent: elements and how to obtain it](https://durgical.com/en/medical-ethics/informed-consent-elements-and-how-to-obtain-it/) - [Decision-making capacity (competence) and how to assess it](https://durgical.com/en/medical-ethics/decision-making-capacity-and-how-to-assess-it/) [← All of medical ethics](https://durgical.com/en/medical-ethics/) Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal. Sources: [The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research](https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html) (U.S. Department of Health and Human Services, Office for Human Research Protections, 1979); [WMA International Code of Medical Ethics](https://www.wma.net/policies-post/wma-international-code-of-medical-ethics/) (World Medical Association, 2022); [Ley 23 de 1981, por la cual se dictan normas en materia de ética médica](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68760) (Función Pública, Gestor Normativo (Colombia), 1981). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/medical-ethics/respect-for-autonomy/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). 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