Merging or ignoring the difference between autonomy and freedom causes conceptual flaws in the analysis. This is evident when referring to ideas based on Kantian autonomy18 as something that can be directly opposed to Millian`s freedom.19 In some ways, this is astounding, especially when Mill On Liberty introduces with the words: Sarafis P, Tsounis A, Malliarou M, Lahana E. Disdisclosure the truth: a dilemma between infling hope and respect patient autonomy in daily clinical practice. Glob J Health Sci. 2014;6(2):128-37. Hankins JM. The Right to Body Self-Determination in Connecticut: Life and Death According to Stamford Hospital v. Vega. Conn Law Rev. 1996;29:945–77.

Respect for patient autonomy is generally considered an important ethical principle in Western countries; Privacy is one of the implications of such respect. Healthcare professionals often face ethical dilemmas during their practice. In recent decades, courts have increasingly been used to resolve persistent ethical dilemmas in both developed and developing countries. However, Chinese and American bioethics differ widely due to the influence of Chinese Confucianism and Western religions, respectively, and there is a lack of comparative studies examining cases of ethical dilemmas between China and the United States. This research focused specifically on issues of patient autonomy, that is, the central principles of truth, confidentiality and informed consent. Participants were asked to describe ethical issues that have arisen in their practice or experience and to describe exactly how they approached these questions, their responses to them, and additional comments on the situations. All recordings were transcribed verbatim. Although the law has evolved to grant patients greater freedoms, ambiguities in the meaning and justification of protecting patients` freedoms cast doubt on the coherence and defensiveness of certain legal developments.

One form of freedom that has developed over the past two decades is greater “negative freedom”; Part of what we call “freedom.” With regard to freedom, measures and principles have been developed to guarantee or improve patients` freedom from the intervention of others. This is consistent with what many understand as Millian liberalism. It is recommended to deny that the doctor knows better, and rather to determine that each individual is best placed to align his own life with the goals that result in the best overall position for them. This freedom is extended only to mentally competent people: unconditional respect for the content of well-being or what serves an individual`s interests evaporates when a patient is likely to make a wrong decision without having the rationality to do so reasonably. Youth, mental retardation and factual ignorance can prevent a person from having a privileged freedom before the law. In the legal developments we have examined, therefore, emphasis is also placed on “positive freedom”; what we call “autonomy”. Autonomy in this sense is not a freedom to claim special treatment. On the contrary, it maintains in the function of reason. And here, the law has developed on the basis of two contradictory foundations that reflect the two starting points of autonomy discussed in Section II. These are rational decisions that take into account an individual`s own values and rational decisions that take into account certain objective or in principle generally acceptable values. The first is the ideal that the law appears to protect, while the second, as enforced by the law, inhibits excessive individualism and insufficient consideration of the well-being of vulnerable people.100 The changes to legal principles described above were introduced with a paradigmatic patient who lives legally according to his or her own values.

Empowering patients is therefore a way to enable individuals to make changes in their lives in a way that is consistent with what they would advocate in a second order.101 In the simplest case, autonomy means self-government. In this fundamental sense, it is not so much a normative concept as an empirical question: we do not know ex ante that (or how much) autonomy is good. Rather, we ask whether autonomy exists in any situation: does a person guide his actions? If so, it is autonomous, if not, it is not. It does not tell us that it must govern itself. Whether or to what extent people should govern themselves are complex issues. There are different problems. For example, there is concern about the authority of “me” in self-government: is a young child capable of autonomy, or is he too ignorant and irrational to govern himself? Is being autonomous an absolute thing, meaning that you are autonomous or not, or is it graduated or context-specific, meaning that you can be more or less autonomous? Is there a particular normative concern because of something, such as an adult, simply because of their ability to be independent? If so, does it also apply to a person with the potential to become independent? Consideration of these issues has dominated ethical debates about doctor-patient interactions, leading to more practical normative questions.