PT  - JOURNAL ARTICLE
AU  - C J McKnight
TI  - Autonomy and the akratic patient.
AID  - 10.1136/jme.19.4.206
DP  - 1993 Dec 01
TA  - Journal of Medical Ethics
PG  - 206--210
VI  - 19
IP  - 4
4099  - http://jme.bmj.com/content/19/4/206.short
4100  - http://jme.bmj.com/content/19/4/206.full
SO  - J Med Ethics1993 Dec 01; 19
AB  - I argue that the distinction which is current in much writing on medical ethics between autonomous and non-autonomous patients cannot cope comfortably with weak-willed (incontinent) patients. I describe a case involving a patient who refuses a blood transfusion even though he or she agrees that it would be in his or her best interests. The case is discussed in the light of the treatment of autonomy by B Brody and R Gillon. These writers appear to force us to treat an incontinent patient either as autonomous, just like a rational agent whose decisions are in accordance with his beliefs or as non-autonomous, like comatose patients or children. Though neither is entirely satisfactory I opt for describing such patients as autonomous but point out that in cases like this the principle of respect for autonomy does not give a determinate answer about how the patient ought to be treated.