Autonomía, consentimiento y bioética: La construcción de la confianza en la práctica sanitaria

Resumen

Personal autonomy, self-determination and bioethics: how consent is built in health care practice.

Bioethics has stressed the importance of personal autonomy and self-determination as an essential element within clinical relationships. Thus, it has expanded the use of the so-called ’informed consent’ as a valuable tool to cope with the decisions and beliefs of the patient. However, this principle of analysis that has served as a defense against the classical paternalism in health practice, has also involved the weakening of other essential elements in that activity: dependence and trust. Moreover, there has been some perversion of informed consent that has resulted in a medicine almost contractual. Therefore, autonomy must be weighed in relation to other classical principles of bioethics in order to create a relational and deliberative model in this discipline, one that assumes the systemic and relational nature of health care practice, where beneficence will not take a paternalistic character.

Key words: Bioethics, autonomy, paternalism, beneficence, informed consent, liberty, dependence, trust, health care practice, complexity.