Page 141 - Human Rights

Faculty of Nursing
Adult care Nursing Department

In addition, in a global culture, especially in the case of children, adolescents, or other persons

with diminished mental capacities, autonomy is not limited to the patient but can extend to other

family members (family autonomy).

At the level of clinical relationship with the patient, all interventions require informed, free, and
expressed consent; consent is even considered imperative for professional ethics. Freedom in

decision-making implies that the patient is truly autonomous to decide.

Assuming that the patient is in full possession of their mental capacities (ethical competence), the

freedom of will implies two points:

1 There is no coercion or external manipulation, especially no threat or sus pectedthreat from any

person, including healthcare professionals.

2 All conditions that may affect the patient’s will are excluded, for example, the effects of
medication, drugs, or alcohol, treatable affective disorders such as depression, or even intense

pain and suffering.

In other words, the physician has the duty to inform the patient, in accessible language, all facts

that are relevant for the patient to decide in full consciousness

. Obviously, necessary prudence is required not only to inform but also to clarify issues with the
patient in such a way that the transmitted information is comprehended with calmness and

serenity.

The greater the risk of the intervention, the greater the importance of obtaining valid and actual
consent, although there are different possible modalities as follows (Nunes 2016):

1 Express consent:

When informed consent is given actively (not tacitly) and orally within the context of a therapeutic

alliance between the doctor and the patient.

130 Academic Year 2025/2026