Abstract

Who is in control of treatment is an issue clinicians address on a daily basis. This represents an ethical dilemma, which sets the principle of autonomy in direct conflict with the principle of beneficence. This article advocates giving autonomy precedence over beneficence to achieve patient control of treatment. Patient control of treatment is essential in chronic disease because the patient is the expert in his or her own goals and values, the sick role is inappropriate in chronic disease and may have devastating emotional consequences, and in actuality the patient is the health care provider.