This article by Terrance F. Ackerman describes the two, sometimes clashing, notions of patient autonomy and physician interference. Patient autonomy is a necessary staple in the doctor patient relationship. It needs to be considered when dealing with patients when it comes to a multitude of scenarios including sharing information, deciding treatment plans, prescribing prescription medications. Ackerman defines patient autonomy as having two key features. The first of those being that: “autonomous behavior is governed by plans of action that have been formulated through deliberation or reflection” (Ackerman, 1982). The second is then stated as: “autonomous behavior issues, intentionally or voluntarily, from choices people make based upon their own life plans” (Ackerman, 1982). These two stipulations are important but can be impeded by certain constraints described Ackerman. These constraints can be physical, cognitive or psychological. Doctors are required to respect autonomous patients however what happens when a patent is constrained by a number of factors in terms of making logical decisions? This is where physician interference comes in.
Non-interference is the physician’s role in patient decision-making. This topic can be difficult to balance with autonomy. Where is the line in which a doctor’s opinion is helpful rather than pushy and unnecessary? Is it possible for non-interference to respect patient autonomy? This also raises the question about how much say should doctors have in medical decisions their patient’s make. Also is that say hindering patient autonomy?
I think these questions can be assessed in a case-by-case basis. While physician interference isn’t welcomed in all cases, I think its necessary in certain situations. I think it’s important for a physician to inform the patient on certain risks or probabilities from the biological standpoint. In terms of certain diseases, the doctor comprehends the course and should inform the patient on the reality of the situation and what they believe is best. For example if a patient is diagnosed with a rare disease, it is the doctors obligation to help provide the patient with the necessary information in order for them to be able to make coherent decisions regarding their medical care. A doctor should no attempt to guide a patient towards a course of action they believe is best, but they should provide the individual with essential information to decide for themselves. Another case would be one in which a patient’s competency is in question. This goes back to Ackerman’s discussion of constraints that impede patient autonomy. If a patient is incapacitated due to physical, cognitive, or psychological constraints then self-governance is obstructed. This is a time when a doctor must interfere in order to make a decision for the patient. In other situations the line is more blurred. A patient’s decisions must be respected and taken seriously by the physician. I think the physician should be able to weigh in on the decision and should be available to answer any questions the patient may have but in order for autonomy to be unharmed, the patient must reach a decision on their own terms.

Works Cited:
Ackerman, T. F. (1982). Why Doctors Should Intervene. The Hastings Center Report, 12(4), 14. doi:10.2307/3560762

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.