The collaborative autonomy model of medical decision-making

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


While the bioethical principle of beneficence originated in antiquity, the ascension of autonomy, or "self-rule," has redefined the physician-patient relationship to the extent that autonomy often dominates medical decision-making. Philosophical and social movements, medical research atrocities, consumerism, and case law have all had their influence on this paradigm shift. Consequently, the contemporary physician encounters an uncertainty in medical practice on how to resolve conflicts that arise in the pursuit of valuing both autonomy and beneficence. This is especially true in the practice of neurologic critical care where physicians may be advising comfort care measures for neurologically devastated patients while surrogates request physiologically futile interventions. This conundrum has been an important subject of the bioethics and social science literature but often this discourse is not disseminated to the clinicians confronting these issues. The purpose of this essay is to present a history of the principles of autonomy and beneficence and then present a shared medical decision-making model, collaborative autonomy, to provide guidance to neurologic critical care providers in how to resolve such dilemmas. Clinical vignettes will help illustrate the model.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalNeurocritical Care
Issue number2
StatePublished - Apr 2014


  • Autonomy
  • Beneficence
  • Critical care
  • Medical ethics
  • Shared decision-making

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine


Dive into the research topics of 'The collaborative autonomy model of medical decision-making'. Together they form a unique fingerprint.

Cite this