Elysa Gordon


Beginning with the proposition that the western medical tradition of emphasizing patient autonomy undermines a patient's ability to limit his or her role in medical decision-making, the author of this student note proposes a model of informed waiver to counterbalance the perceived legal bias towards informed consent. Part I explains the western notion of patient autonomy in two distinct ways: first, autonomy is rooted in western ideals of self-governance and political freedom; second, the article discusses how this idea has been developed in American courts. In Part II, the author draws on anecdotal and empirical evidence to demonstrate that autonomy is not an appropriate standard for the experience of all patients. Finally, the article concludes by proposing a framework whereby culture might be incorporated into a definition of autonomy in legal and medical practice. In particular, the author offers a notion of informed waiver as a compromise for patients who choose to forego the western-defined approach to decision-making.