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Dynamics of Biomedical Ethics and Autonomy


With the millennium having clocked nine years old, leaders from different nations have experienced a lot of hardships over this period. The business world has also not been spared the ordeal with scandals such as WorldCom being witnessed. Local governments have seen adjudicators and other law enforcers convicted for criminal behavior. In some nations, citizens have again and again been poked by the news of the government officials caught spreading misleading information. This has to lead to most of the citizens not trusting any kind of leader. These problems have likely been caused by poor ethical decision-making resulting from their leaders. Numerous researches have been conducted to analyze the impacts of leaders in the behavior changes among their subjects. Nevertheless, it is important to know that leadership does not involve only the leaders but also those being lead make part of the leadership.

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Changes in society

Society is dynamically changing at a hardly noticeable rate. Looking back at the growth in society over a long period, it is possible to notice various signs of development in society. There has been improvement in self-understanding among the citizens due to the growth in the importance of sovereignty and the spirited implementation of groups’ partition. The awareness that citizens have about themselves and their ideals today is different from that of thirty years ago. According to a publication in 1985 by Habits of the Heart (HH), individualism has been a unique characteristic behavior among Americans. This has occasionally been regulated by the emphasis on the common good viewed in the religious teachings and community republicanism. However, the social cohesion fostered by the religious teachings and the community republicanism has been wearing away of late. This is gradually being substituted with the notion of individualism in society. One of the major contributing factors to these changes is the continuing disintegration of the society into smaller social groups such as nuclear families and in the long run a lonely people. These groups have found themselves competing rather than working together as each group pursues its independent needs(Bellah, Madsen & Sullivan,1985, pp.124-37).

Ethical suggestions

Over the past thirty years, there has been a great expansion of ethical suggestions in the field of Biomedical Ethics or simply Bioethics. One of the major impacts of this shift has been the recognition of the patients’ freedom. As patient autonomy grows in meaning, it has challenged the dominion of the theory of the goodness of the physicians called paternalism. Over the years, the issue of independence has in many times overridden the importance of paternalism. The idea has received great support from the masses with both The Uniform Rights of the Terminally Ill Act and the federal Patient Self-Determination Act supporting the rights of the patients or their deputies in the decision-making process. These laws emphasize the idea of patients’ autonomy at the expense of medical specialists making their role appear to be of less importance. The issue of who to decide poses a great pressure between the main beliefs of the patient autonomy and paternalism. For instance, most of the abortions conducted over the last thirty years were faced with a struggle between the pregnant women who had the power of deciding on whether to carry it out and the state’s power that tries to control the incidences of women taking abortions. It can be argued that this tension between individual freedom in making decisions and society paternalism undermines almost all the current efforts of biomedical ethics. In the past, doctors could tell patients that the test results indicated that there was a need for them to undergo surgeries to remove tumors and proceed in making the needed preparations without resistance from the patients. Today, physicians have to explain to the patients all the alternative available treatment options, and the discretion of making the decision is left with the patients. This has often led to patients making decisions that do not coincide with the physicians’ knowledge leading to them dying sooner or later. While the medical team could be able to save patients suffering from cardiac arrest, the majority of the people advocate for the doctors not to resuscitate. This leaves the doctors standing beside the bed and watching as the patient succumb to the arrest while they could have saved the situation.

Individual freedom

Funny enough, as the issue of support for the patients’ freedom becomes increasingly accepted in the medical field, many medical professionals have started changing their stand on the issue with most of them supporting it also. Most of the professionals argue that they have decided to support it because a time will come when they will also require the same to be reciprocated to them. This has lead to the creation of a ground where the physicians and the patients can discuss and come up with constructive decisions. The fight for power in biomedical ethics indicates the desire by people in making their own decisions for their life. Traditionally, society had bestowed the power of making decisions to the professionals where the doctors could decide on what is better for their patients; police maintain the social order as the teacher devised methods of rating their students. Autonomy suppresses the community’s effort in controlling the sometimes rebellious practice of individual freedom. The rise of freedom has resulted in the reversing of roles. Initially, the doctors acted as the leaders while the patients were their subjects who had no other but to follow what the doctors said. Currently doctors, in as much as they know, the final decision remains with the patients. Respect for the patients’ freedom asks for the doctors to fully inform the patients of all possible alternatives concerning their treatment. They are also expected to tell the patients the truth about their conditions and keep the information regarding their condition classified. This has resulted in the reduction of instances where doctors may appeal to the opinion of curative privilege by which the doctors would not disclose to the patient’s information regarding their conditions for their good (Potter, 1988, pp.30-43).


The gradual but stable growth of individual autonomy in the field of biomedical ethics has changed how people react to rule when it comes to matters about the public. The conflict between the patients and the physicians is changing to the direction of a more productive dialogue between them. There has been an integration of the patients’ views as well as those of the doctor when it comes to making decisions with regards to what is good for the patients.


Bellah, R. N., Madsen, R. & Sullivan, W.M. (1985). Habits of the Heart. New York: Harper & Row, Publishers.

Potter, V. R. (1988). Global Bioethics. Lansing: Michigan State University Press.

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