[Relationship between autonomy and integrity in medical ethics]. 1990

E D Pellegrino
Universidad de Georgetown, Cátedra John Carroll de Medicina y Humanidades Médicas.

The emergence of autonomy as a sociopolitical, legal, and moral concept has had a profoundly influenced medical ethics. It has shifted the center of decision-making from the physician to the patient and reoriented the physician-patient relationship so that it is more open and frank, and more respectful of the dignity of the person of the patient. In general, the ascendance of autonomy has protected patients against the grosser violations of their autonomy and integrity, so widely accepted as ethically permissible in the past. However, the ethical principle of autonomy is not sufficient to guarantee the nuances, the subtleties, and the full meanings of respect for persons in medical transactions. As a foundation for medical relationships, the concept of integrity is richer, more fundamental, and more closely tied to what it is to be a whole human person--corporeally, psychologically, and axiologically. The moral implications of integrity are more demanding albeit more difficult to capture in legal language or in the procedures of informed consent. Yet, for the reasons outlined in this paper, we should deepen our grasp of the notion that autonomy depends upon preserving the integrity of persons--and that both depend on the physician being a person of integrity.

UI MeSH Term Description Entries
D010344 Patient Advocacy Promotion and protection of the rights of patients, frequently through a legal process. Patient Ombudsmen,Patient Representatives,Clinical Ombudsman,Patient Ombudsman,Advocacy, Patient,Ombudsman, Clinical,Ombudsman, Patient,Ombudsmen, Patient,Patient Representative,Representative, Patient,Representatives, Patient
D010358 Patient Participation Patient involvement in the decision-making process in matters pertaining to health. Patient Activation,Patient Empowerment,Patient Engagement,Patient Involvement,Patient Participation Rates,Activation, Patient,Empowerment, Patient,Engagement, Patient,Involvement, Patient,Participation Rate, Patient,Participation Rates, Patient,Participation, Patient,Patient Participation Rate
D004992 Ethics, Medical The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families. Medical Ethics
D006694 Holistic Health Health as viewed from the perspective that humans function as complete, integrated units rather than as aggregates of separate parts. Holistic Medicine,Holistic Therapies,Medicine, Holistic,Whole Person Health,Wholistic Health,Medicine, Wholistic,Wholistic Health Care,Wholistic Medicine,Wholistic Therapies,Care, Wholistic Health,Health Care, Wholistic,Health, Holistic,Health, Whole Person,Health, Wholistic,Holistic Therapy,Person Health, Whole,Therapies, Holistic,Therapies, Wholistic,Therapy, Holistic,Therapy, Wholistic,Wholistic Therapy
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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