Against doctor's orders: the force and limits of personal autonomy in the health care setting.

A. Introduction Our aim in this paper is to consider two related questions, which go to the heart of the larger concern of confl ict between a patient’s choice and a medical professional’s judgment about the proper course of treatment and care. First, how should a medical professional respond to a patient’s refusal to conform to medically necessary dietary advice? Second, having been confronted with such a refusal, how should that medical professional then respond to the patient’s request of an alternative but potentially harmful dietary choice? We will examine these questions – of refusal and then of contra-indicated demands – by reviewing and analyzing pertinent Canadian authorities, giving particular consideration to the applicable standard of care that is required of a medical professional in the circumstances just described.