Medical Autonomy Quotes

What worries me most about the proposals for legalized assisted suicide is their veneer of beneficence—the medical determination that for a given individual, suicide is reasonable or right. It is not about autonomy but about nondisabled people telling us what’s good for us. In the discussion that follows, I argue that choice is illusory in a context of pervasive inequality. Choices are structured by oppression. We shouldn’t offer assistance with suicide until we all have the assistance we need to get out of bed in the morning and live a good life. Common causes of suicidality—dependence, institutional confinement, being a burden—are entirely curable.

Only two things matter in the reproductive health debate: the medical opinions of doctors, and the will of women. Also, feminism is intricately connected with all aspects of our society, including health, but also labor and the economy. A woman can't be an equal player in our society until she has total autonomy, and that includes determining the destiny of her own body.

What is odd, perhaps, is how the primacy of patient autonomy and informed consent over efficacy—which is what we’re talking about here—was presumed, but not actively discussed within the medical profession. Although the authoritative and paternalistic reassurance of the Victorian doctor who ‘blinds with science’ is a thing of the past in medicine, the success of the alternative therapy movement—whose practitioners mislead, mystify and blind their patients with sciencey-sounding ‘authoritative’ explanations, like the most patronising Victorian doctor imaginable—suggests that there may still be a market for that kind of approach.

Man's consciously lived fragility, individuality and relatedness make the experience of pain, of sickness and of death an integral part of his life. The ability to cope with this trio autonomously is fundamental to his health. As he becomes dependent on the management of his intimacy, he renounces his autonomy and his health must decline.

Autonomy is absolutized in principle and practice. This may lead to the second response, namely, that physicians will accede to whatever the patient or valid surrogate wants. This prompts the physician to transfer all responsibility to patients, family, or friends. This occurs with alarming frequency in the care of infants, the elderly, and demented patients who may be over- or under-treated because their surrogates demand it. Indeed,

In an effort to justify the prohibition of 186 species of mushroom, including the ‘offending’ psilocybin containing mushrooms sold to the public through smart shops, Dutch Minister of Health, Dr. Ab Klink, refers to the high instance of anxiety and ‘even paranoia’ experienced by those who use them. He makes no mention of the very low incidence of harm (social or otherwise) involving fresh psilocybin containing mushrooms, or the disproportionate number of alcohol and tobacco related deaths, injuries and social disruptions. We are left with an impression that the Minister believes the state has a duty to banish fear itself. This exemplifies the degree to which scientific and medical rationales may become confused with moral and ideological commitments that undermine the ‘wall of separation between Church and State,’ a fundamental tenet of modern democracy.

Abortion is one of the most commonly performed medical procedures in the United States, and it is tragic that many women who have abortions are all too often mischaracterized and stigmatized, their exercise of moral agency sullied. Their judgment is publicly and forcefully second-guessed by those in politics and religion who have no business entering the deliberation. The reality is that women demonstrate forethought and care; talk to them the way clergy do and witness their sense of responsibility. Women take abortion as seriously as any of us takes any health-care procedure. They understand the life-altering obligations of parenthood and family life. They worry over their ability to provide for a child, the impact on work, school, the children they already have, or caring for other dependents. Perhaps the woman is unable to be a single parent or is having problems with a husband or partner or other kids.2 Maybe her contraception failed her. Maybe when it came to having sex she didn’t have much choice. Maybe this pregnancy will threaten her health, making adoption an untenable option. Or perhaps a wanted pregnancy takes a bad turn and she decides on abortion. It’s pretty complicated. It’s her business to decide on the outcome of her pregnancy—not ours to intervene, to blame, or to punish. Clergy know about moral agency through pastoral work. Women and families invite us into their lives to listen, reflect, offer sympathy, prayer, or comfort. But when it comes to giving advice, we recognize that we are not the ones to live with the outcome; the patient faces the consequences. The woman bears the medical risk of a pregnancy and has to live with the results. Her determination of the medical, spiritual, and ethical dimensions holds sway. The status of her fetus, when she thinks life begins, and all the other complications are hers alone to consider. Many women know right away when a pregnancy must end or continue. Some need to think about it. Whatever a woman decides, she needs to be able to get good quality medical care and emotional and spiritual support as she works toward the outcome she seeks; she figures it out. That’s all part of “moral agency.” No one is denying that her fetus has a moral standing. We are affirming that her moral standing is higher; she comes first. Her deliberations, her considerations have priority. The patient must be the one to arrive at a conclusion and act upon it. As a rabbi, I tell people what the Jewish tradition says and describe the variety of options within the faith. They study, deliberate, conclude, and act. I cannot force them to think or do differently. People come to their decisions in their own way. People who believe the decision is up to the woman are typically called “pro-choice.” “Choice” echoes what is called “moral agency,” “conscience,” “informed will,” or “personal autonomy”—spiritually or religiously. I favor the term “informed will” because it captures the idea that we learn and decide: First, inform the will. Then exercise conscience. In Reform Judaism, for instance, an individual demonstrates “informed will” in approaching and deciding about traditional dietary rules—in a fluid process of study of traditional teaching, consideration of the personal significance of that teaching, arriving at a conclusion, and taking action. Unitarian Universalists tell me that the search for truth and meaning leads to the exercise of conscience. We witness moral agency when a member of a faith community interprets faith teachings in light of historical religious understandings and personal conscience. I know that some religious people don’t do

But ask: ‘Whose autonomy?’ Consider a person who is faced with a decision about whether to have life-prolonging treatment for cancer. The biological man may want to cling onto life with the help of any available technology. The sentimental family man might want to see his children for those extra few months. The considerate family man might want to die early so as ‘not to be a burden’ to his family. The man who has read John Stuart Mill and drafted a ‘life-plan’ might want to die as he has lived, with a proud independence unfettered by morphine and incontinence. The religious man might think that sophisticated therapy frustrates the will of God. And so on.

The practice of euthanasia, under some circumstances, is morally required by the two most widely regarded principles that guide medical practice: respect for patient autonomy and promoting patient’s best interests. In the Netherlands and Belgium active euthanasia may be carried out within the law.

First, they contend that compassion makes euthanasia morally mandatory. We wouldn’t let our dog continue to scream for years with uncontrolled pain: we’d take it to the vet to be put down. Why should we deny to humans what basic decency makes us do to our dogs? And second, they emphasize autonomy. Our lives are our own, they say. We can decide what to do with them. If we choose to end them, that’s our business.

I believe that for all its many flaws, the United States remains, in the phrase that is attributed to Ronald Reagan but actually dates back to John Wintrop four centuries ago, ‘a city upon a hill.’ I believe we will take back our freedoms from the would-be authoritarians who spent 2020 trying to cage us in our homes, 2021 chipping away at our medical autonomy, and both years censoring our freedom to speak and debate. All for our own good, of course. I believe in the Constitution and the Bill of Rights and the rule of law. I believe they, and we, are more powerful than this crummy little virus. I believe truth will prevail. I have to. We all have to The alternative is impossible to imagine.

It is wholly justified to label vaccine passports as draconian, coercive, and one of the most dangerous government interventions in human history; an intervention that undermined voluntary consent to medical procedures and threatened the core principles of what it means to be an autonomous human being.

First, I am thrilled that paramedics are finally getting the respect they deserve for being the professionals they can be. The scope of practice is expanding, and patient care modalities are improving, seemingly by the minute. Patient outcomes are also improving as a result, and EMS is passing through puberty and forging into adulthood. On the other hand, autonomy in the hands of the “lesser-motivated,” can be a very dangerous thing. You know as well as I do that there are still plenty of providers who operate from a subjective, complacent, and downright lazy place. Combined with the ever-expanding autonomy, that provider just became more dangerous than he or she ever has been – to the patients and to you. Autonomy in patient care places more pressure for excellence on the provider charged with delivering it, and also on the partner and crew members on scene. Since the base hospital is not involved like it once was, they are likewise less responsible for the errors and omissions of the medics on the scene. Now more than ever, crew members are being held to answer for the mistakes and follies of their coworkers; now more than ever, EMS providers are working without a net. What’s next? I predict (and hope) emergency medical Darwinism is going to force some painful and necessary changes. First, increasing autonomy is going to result in the better and best providing superior patient care. More personal ownership of the results is going to manifest in outcomes such as increased cardiac arrest survival rates, faster and more complete stroke recovery, and significantly better outcomes for STEMI patients, all leading to the brass ring: EMS as a profession, not just a job. On the flip side of that coin, you will see consequences for the not-so-good and completely awful providers. There will be higher instances of licensure action, internal discipline, and wash-out. Unfortunately, all those things will stem from generally preventable negative patient outcomes. The danger for the better provider will be in the penumbra; the murky, gray area of time when providers are self-categorizing. Specifically, the better provider who is aware of the dangerously poor provider but does nothing to fix or flush him or her, is almost certain to be caught up in a bad situation caused by sloppy, complacent, or ultimately negligent patient care that should have been corrected or stopped. The answer is as simple as it is difficult. If you are reading this, it is more likely because you are one of the better, more committed, more professional providers. This transition is up to you. You must dig deep and find the strength necessary to face the issue and force the change; you have to demand more from yourself and from those around you. You must have the willingness to help those providers who want it – and respond to those who need it, but don’t want it – with tough love by showing them the door. In the end, EMS will only ever be as good as you make it. If you lay silent through its evolution, you forfeit the right to complain when it crumbles around you.

Martí still had to consider himself lucky, since in 1871 eight medical students had been executed for the alleged desecration of a gravesite in Havana. Those executed were selected from the student body by lottery, and they may not have even been involved in the desecration. In fact, some of them were not even in Havana at the time, but it quickly became obvious to everyone that the Spanish government was not fooling around! Some years later Martí studied law at the Central University of Madrid (University of Zaragoza). As a student he started sending letters directly to the Spanish Prime Minister insisting on Cuban autonomy, and he continued to write what the Spanish government considered inflammatory newspaper editorials. In 1874, he graduated with a degree in philosophy and law. The following year Martí traveled to Madrid, Paris and Mexico City where he met the daughter of a Cuban exile, Carmen Zayas-Bazán, whom he later married. In 1877 Martí paid a short visit to Cuba, but being constantly on the move he went on to Guatemala where he found work teaching philosophy and literature. In 1878 he published his first book, Guatemala, describing the beauty of that country. The daughter of the President of Guatemala had a crush on Martí, which did not go unnoticed by him. María was known as “La Niña de Guatemala,” the child of Guatemala. She waited for Martí when he left for Cuba, but when he returned he was married to Carmen Zayas-Bazán. María died shortly thereafter on May 10, 1878, of a respiratory disease, although many say that she died of a broken heart. On November 22, 1878, Martí and Carmen had a son whom they named José Francisco. Doing the math, it becomes obvious as to what had happened…. It was after her death that he wrote the poem “La Niña de Guatemala.” The Cuban struggle for independence started with the Ten Years’ War in 1868 lasting until 1878. At that time, the Peace of Zanjón was signed, giving Cuba little more than empty promises that Spain completely ignored. An uneasy peace followed, with several minor skirmishes, until the Cuban War of Independence flared up in 1895. In December of 1878, thinking that conditions had changed and that things would return to normal, Martí returned to Cuba. However, still being cautious he returned using a pseudonym, which may have been a mistake since now his name did not match those in the official records. Using a pseudonym made it impossible for him to find employment as an attorney. Once again, after his revolutionary activities were discovered, Martí was deported to Spain. Arriving in Spain and feeling persecuted, he fled to France and continued on to New York City. Then, using New York as a hub, he traveled and wrote, gaining a reputation as an editorialist on Latin American issues. Returning to the United States from his travels, he visited with his family in New York City for the last time. Putting his work for the revolution first, he sent his family back to Havana. Then from New York he traveled to Florida, where he gave inspiring speeches to Cuban tobacco workers and cigar makers in Ybor City, Tampa. He also went to Key West to inspire Cuban nationals in exile. In 1884, while Martí was in the United States, slavery was finally abolished in Cuba. In 1891 Martí approved the formation of the Cuban Revolutionary Party.

Building on the Pentagon’s anthrax simulation (1999) and the intelligence agency’s “Dark Winter” (2001), Atlantic Storm (2003, 2005), Global Mercury (2003), Schwartz’s “Lockstep” Scenario Document (2010), and MARS (2017), the Gates-funded SPARS scenario war-gamed a bioterrorist attack that precipitated a global coronavirus epidemic lasting from 2025 to 2028, culminating in coercive mass vaccination of the global population. And, as Gates had promised, the preparations were analogous to “preparing for war.”191 Under the code name “SPARS Pandemic,” Gates presided over a sinister summer school for globalists, spooks, and technocrats in Baltimore. The panelists role-played strategies for co-opting the world’s most influential political institutions, subverting democratic governance, and positioning themselves as unelected rulers of the emerging authoritarian regime. They practiced techniques for ruthlessly controlling dissent, expression, and movement, and degrading civil rights, autonomy, and sovereignty. The Gates simulation focused on deploying the usual psyops retinue of propaganda, surveillance, censorship, isolation, and political and social control to manage the pandemic. The official eighty-nine-page summary is a miracle of fortune-telling—an uncannily precise month-by-month prediction of the 2020 COVID-19 pandemic as it actually unfolded.192 Looked at another way, when it erupted five years later, the 2020 COVID-19 contagion faithfully followed the SPARS blueprint. Practically the only thing Gates and his planners got wrong was the year. Gates’s simulation instructs public health officials and other collaborators in the global vaccine cartel exactly what to expect and how to behave during the upcoming plague. Reading through the eighty-nine pages, it’s difficult not to interpret this stunningly prescient document as a planning, signaling, and training exercise for replacing democracy with a new regimen of militarized global medical tyranny. The scenario directs participants to deploy fear-driven propaganda narratives to induce mass psychosis and to direct the public toward unquestioning obedience to the emerging social and economic order. According to the scenario narrative, a so-called “SPARS” coronavirus ignites in the United States in January 2025 (the COVID-19 pandemic began in January 2020). As the WHO declares a global emergency, the federal government contracts a fictional firm that resembles Moderna. Consistent with Gates’s seeming preference for diabolical cognomens, the firm is dubbed “CynBio” (Sin-Bio) to develop an innovative vaccine using new “plug-and-play” technology. In the scenario, and now in real life, Federal health officials invoke the PREP Act to provide vaccine makers liability protection.

At times like the present, however, when more and more physicians hesitate to perform abortions for fear that they will hurt their image, and when medical schools no longer teach the procedure to their regular medical students, women lose their equal access to abortion, and poor women in particular are denied reproductive autonomy.172

When your child is in the hospital, suddenly somebody else is feeding them, somebody else is changing their pants, somebody else is deciding how and when they will be bathed. It takes all the autonomy of being a parent away, even for folks who have had a lot of medical experience. It would be that much harder if you were from another culture and didn't understand the purpose of all these things.

That those who entered such nursing homes needed meaning—a life, an identity, dignity, self-respect, a degree of autonomy—was ignored or bypassed; “care” was purely mechanical and medical.

My body, my work, my voice, my confidence, my power, my determination to demand a life as potent, vibrant, public and complex as any man's. My abortion wasn’t intrinsically significant, but it was my first big grown-up decision – the first time I asserted, unequivocally: ‘I KNOW THE LIFE I WANT AND THIS IS NOT IT"; the moment I stopped being a passenger in my own body and grabbed the rudder... The truth is I don't give a damn why anyone has an abortion. I believe unconditionally in the right of people with uteruses to decide what grow inside of their body and feeds on their blood and endangers their life and reroutes their future. There are no "good" abortions and "bad" abortions, there are only pregnant people who want them and pregnant people who don't, pregnant people who have access and support and pregnant people who face institutional roadblocks and lies... For that reason, we simply MUST talk about it. The fact that abortion is still a taboo subject means that opponents of abortion get to define it however suits them best. They can cast those of us who have had abortions as callous monstrosities and seed fear in anyone who might need one by insisting that the procedure is always traumatic, always painful, and always an impossible decision. Well we're not and it's not. The truth is that life is unfathomably complex and every abortion story is as unique as the person who lives it. Some are traumatic, some are even regretted, but plenty are like mine... My abortion was a normal medical procedure that got tangled up in my bad relationship, my internalized fatphobia, my fear of adulthood, my discomfort with talking about sex; and one that, because of our culture’s obsession with punishing female sexuality and shackling women to the nursery and the kitchen, I was socialized to approach with shame and describe only in whispers. But the procedure itself was the easiest part. Not being able to have one would have been the real trauma.

Medical training tends to be somewhat black-and-white. Students learn that there can be only one right answer, often with little credit given for applying yourself, doing your best, or trying your hardest.

And yet the debate over AB 1421, as I discovered in San Francisco, touched upon crucial issues of autonomy and civil liberties. The bill makes the assumption that people who display a certain level of mental disorder are no longer capable of choosing their own treatment, including medication, and therefore must be forced into doing so.