Dilemmas regarding the informed consent in the informative model of the doctor-patient relationship

The author presents a case in which the patient refused the continuation of medical care in a surgical emergency and which evolved dramatically, leading to the patient's death. The doctor's options against the patient's refusal are analyzed both in terms of patient autonomy and the beneficence of medical care. The discussion includes a comparison between the paternalistic model and the informative model of the doctor-patient relationship, as well as the moral and legal values of informed consent. It is argued that patient autonomy, as a fundamental expression of individuality, with its unambiguous character, may conflict with the expectations society itself projects on medical care; it may also conflict with professional independence as a value of the same autonomy, but this time seen from the perspective of the physician. Informed consent is supported by legal provisions which do not provide an optimal solution, free of conflict, in cases such as the one hereby presented. The legal liability of the physicians is a possibility: but even more, their moral burden in cases where the "best interest of the patient" means his death is a certainty.