AUTONOMY AND THE DOCTOR-PATIENT RELATIONSHIP IN END-OF-LIFE: DELINEATING THE CONTOURS OF THE PATIENT'S AND PROFESSIONAL'S PRIVATE AUTONOMY

Abstract

The end of life poses profound ethical challenges in the relationship between patient and healthcare professional, especially regarding the balance between the patient's private autonomy and the physician's professional autonomy. This article aims to outline the possible contours of these autonomies, their interactions, limits, and tensions, considering practices such as palliative care, advance directives, orthothanasia, dysthanasia, and clinical communication. The starting point consists of mapping the central concepts related to patient autonomy and professional autonomy in end-of-life care, regarding their definitions, implications, and normative bases, based on the analysis of some clinical cases and practical dilemmas, such as palliative care, advance directives, refusal of treatment, dysthanasia/orthothanasia, in which these autonomies confront or overlap, with the perspective of identifying the ethical, legal, and practical limits of the autonomy of both (patient and professional). The article proposes suggestions for an ethical clinical practice that respects the patient, preserves dignity, and also recognizes the moral and technical integrity of the professional. This is a qualitative bibliographical research study, based on deductive methodology. As part of the conclusion, it is understood that patient and professional autonomy are not opposed, but complementary, requiring dialogue, legal clarity, ethical education, and a clinical practice that recognizes vulnerabilities, emotional support, and shared responsibility.