Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Autonomy is a central ethical principle of medical practice. The physician's autonomy is usually expressed in concert with the other, overriding, ethic of medical care: beneficence. The autonomy of patients, however, has had a growing influence on medical decision-making and can complicate the process. ⋯ Such communication, however, can be obstructed by social values about life and death and the urgent nature of medical care in these situations. To show how such communication ought to be incorporated into medical decision-making, one of the most difficult situations is examined hypothetically: the patient who has a DNR order but who consents to undergo anaesthesia and surgery. In these cases, frequent communication between physician and patient about each therapy and its effect most often will resolve dilemmas.