• E D Pellegrino.
• Universidad de Georgetown, Cátedra John Carroll de Medicina y Humanidades Médicas.
• Bol Oficina Sanit Panam. 1990 May 1; 108 (5-6): 379-90.

AbstractThe emergence of autonomy as a sociopolitical, legal, and moral concept has had a profoundly influenced medical ethics. It has shifted the center of decision-making from the physician to the patient and reoriented the physician-patient relationship so that it is more open and frank, and more respectful of the dignity of the person of the patient. In general, the ascendance of autonomy has protected patients against the grosser violations of their autonomy and integrity, so widely accepted as ethically permissible in the past. However, the ethical principle of autonomy is not sufficient to guarantee the nuances, the subtleties, and the full meanings of respect for persons in medical transactions. As a foundation for medical relationships, the concept of integrity is richer, more fundamental, and more closely tied to what it is to be a whole human person--corporeally, psychologically, and axiologically. The moral implications of integrity are more demanding albeit more difficult to capture in legal language or in the procedures of informed consent. Yet, for the reasons outlined in this paper, we should deepen our grasp of the notion that autonomy depends upon preserving the integrity of persons--and that both depend on the physician being a person of integrity.

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