An open future? The principle of autonomy within medical 'codes of conduct' versus the heteronomy effects of predictive medicine

Abstract

Traditionally, the average code of conduct within Western health care starts from the autonomy of the patient. In addition, medicine today is 'evidence based' and the patient is an 'informed consent'. Yet, the individual autonomy of the patient in health care is not simply enhancing today. Quite a few fundamental changes have and are currently at work within health care, which I will summarize here with the paradigm of predictive medicine. One of the characteristics of this paradigm is the increase of medical consults which are not autonomously chosen by an individual. For reasons of public health and diminishing of health risks or for reasons of prevention, on one hand we are dealing with ethical codes centered around the autonomy of patients and the face-to-face relations with health care workers, on the other, we are dealing with a society that takes an increasingly greater medical initiatives. Therefore, the question arises if predictive medicine confronts us with the limits of an ethical code as we know it today. Is there not an urgent need for a political code of conduct in health care? © 2008 Versita Warsaw and Springer-Verlag.