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CONCERNING THE CONCEPT OF THE “PATIENT`S RIGHT TO AUTONOMY”
Abstract
The concept of patient’s rights itself was fairly known before the last four or five decades, and medical malpractice of all kinds made the aggrieved party to seek redress at a court; but no special legislation, apart from rare exceptions, has ever existed to anchor the patient’s rights before the late 20th century. In the civil law tradition of the 20th century, especially its earlier decades, doctors could be held criminally or civilly liable for a wide variety of malpractice, including unauthorized medical intervention or divulgation of patient’s information, though such provisions did not develop actual rights, were quite general in their nature, and were individually assessed by the courts in each case. Within in the gradual change in the doctrines of medical law, the term “autonomy”, shaping the patient’s right to decide what medical interventions could or could not be performed upon his body, intervened into the existing legal scholarship, which was later augmented with various issues, such as access to medical records of the patient, refusal of blood transfusion, participation in medical experiments, deciding upon end-of-life situations or relating to various reproductive law considerations, not always permitted by national law. Many of these rights are much older than the concept of patient’s autonomy themselves, and have developed in the case law which itself has originated from lawsuits against doctors and hospitals for acts, being nearly obscure in the existing legal doctrine, such as unauthorized medical experiments. The given paper is aimed to discuss the development and overall gist of the patient’s right to autonomy, as well as some of its early interpretations in civil law doctrine
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References17
Mainly a patient’s rights law, i.e. the Latvian Patient’s Rights Law of 2009: Pacientu tiesību likums, Latvijas Vēstnesis, 205, 30.12.2009
Mazure, L. 2011. Pacienta griba un tДЃs civiltiesiskДЃ aizsardzД«ba: promocijas darbs. RД«ga: Latvijas UniversitДЃte.
TomГЎЕЎ DoleЕѕal, PrГЎvnГ povaha informovanГ©ho souhlasu a nГЎsledky neГєplnГ©ho pouДЌenГ z hlediska civilnГho prГЎva, ДЊasopis zdravotnickГ©ho prГЎva a bioetiky, Vol. 9 (1) (2019)
OLG Bremen, 31.07.1979 - 1 U 47/79, para. 15-et seq.; BGH, 23.11.1982; VI ZR 222/79, para. 17-27; 30.
E. Deutsch, Das Persönlichkeitsrecht des Patienten, Archiv für die civilistische Praxis 192. Bd., H. 3 (1992).30 Section Law DOI: 10.35603/sws.iscss.2021/s02.03
L. Oppenheim, Das ärztliche Recht zu körperlichen Eingriffen an Kranken und Gesunden, Benno Schwabe, Verlagsbuchhandlung, Basel, 1890.
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Salgo v. Leland Board etc. Trustees, 154 Cal. App. 2d 560, at p. 578-579 (1957) [Civ. No. 17045. First Dist. Div. One. Oct. 22, 1957]
Cons. Chavonin c. Dr. L…, Admin. de l’Assistance Publique et Soc. de laboratoires Thorande, Trib. civ. de la Seine (1 Chambre), 16 mai 1935, Dall. Heb. 1935.390, 390- 391, Dall. Per. 1936 II 9, 13-14; appeal: L. c. Consorts Chavonin et Cie des produits chimiques de la Sorbonne, Cour d'Appel de Paris, 1 Chambre, 11 mai 1937, Dall. Hebd. 1937.340, 340-341
Marc I. Steinberg, The California Natural Death Act--A Failure to Provide for Adequate Patient Safequards and Individual Autonomy, 9 Conn. L. Rev. 203, 214-220 (1977). The term “patient autonomy” in the earlier years was also referred to in the sense of his right to refuse treatment, especially in connection with end-of-life issues, see. David L. Jackson; Stuart Younger, Patient Autonomy and Death with Dignity: Some Clinical Caveats, 20 Jurimetrics J. 348, 355-359 (1980). Seemingly, the concept (at least its American or Canadian version) was initially strongly tied with issues of passive euthanasia, which became a subject of litigation in the 1970s.
Juliana Hasl, Patient Autonomy and the Right to Refuse Treatment: Available Remedies / Comment, 33 St. Louis U. L. J. 711, 713-714 (1989). J. Hasl held that the right to autonomy derives from the right to bodily integrity, but is subject to a number of limitations, which were borne in the jurisprudence of the courts, primarily within the balance of the State’s interest to preserve life, the private interest, and protecting the interests of the third parties. Satz v. Perlmutter, 362 So. 2d 160, 162-164 (Fla. Dist. Ct. App. 1978); 379 So. 2d 359, 361-362 (Fla. 1980) [affirmed].
Joan Loughrey, The Confidentiality of Medical Records: Informational Autonomy, Patient Privacy, and the Law, 56 N. Ir. Legal Q. 293, 294-300; 303-306 (2005)
Tracy E. Miller, Do-Not-Resuscitate Orders: Public Policy and Patient Autonomy The Care of the Dying: A Symposium on the Case of Betty Wright, 17 L. Med. & Health Care 245, 248-252 (1989)
See., for instance, Margaret Brazier, Patient Autonomy and Consent to Treatment: The Role of Law, 7 Legal Stud. 169, 173-178 (1987); Anthony R. LoBiondo, Patient Autonomy and Biomedical Research: Judicial Compromise in Moore v. Regents of the University of California, 1 Alb. L. J. Sci. & Tech. 277, 291-300 (1991).
Accord the judgment of the Supreme Court of Justice of the Nation of Argentine in the case of Marcelo Diaz (2015): D., M.A. s/ Declaración de Incapacidad, Corte Suprema de Justicia de la Nacion, 7 de julio de 2015, CSJ 376/2013 (49-D). (see the court’s justification of approving the decision to terminate life-support).
Edmund D. Pellegrino, Patient and Physician Autonomy: Conflicting Rights and Obligations in the Physician-Patient Relationship, 10 J. Contemp. L. & P. 47, 50 (1994)
For instance, see an American judgment from the state of Colorado, where an incapacitated person impugned a court order authorizing his guardian, the Morgan County
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