Michael Jackson and the limits of patient autonomy

Abstract

Dr Conrad Murray was convicted of the involuntary manslaughter of Michael Jackson for negligently causing his death when complying with Jackson’s request to give him the anaesthetic propofol at home. The case raises the issue of the relative nature of patient autonomy, because the other bioethical principles of beneficence, non-maleficence and justice or fairness must also be applied where appropriate. Doctors should not accede to requests from their patients to engage in unethical or illegal conduct, as such requests will be no defence to disciplinary or criminal charges. Such requests will also be no defence to civil actions if the harmful conduct by the doctor is the result of illegality, fraud or gross negligence. South African doctors faced with requests similar to those received by Dr Murray from Jackson will be judged by the standard of reasonably competent practitioners in the same situation. Doctors are well advised to refuse requests to circumvent good medical practice and instead to seek other remedies, even if it means limiting patient autonomy and losing their patients.