This is the single most important word and concept the reader of this book must grasp. Philosophically, it refers to the fundamental principle that all humans are independent moral agents with the personal capacity to make moral decisions and act on them. To the largest extent, life is about choice, your choices.

The word derives from the Greek autonomia, meaning “self-rule.” In modern days, autonomy most often equates with the phrase, self-determination. Individuals are autonomous when their actions are truly their own without coercion or inappropriate influence.

Sometimes when judges hand down decisions, they really hit the spot. Sometimes their words are not too legalistic and they nail the beauty, power and scope of their decisions in terms most can understand.

Certainly one would think all legal decisions are important. However, one of the core principles in western thought and law, one of the guiding lights of our constitution and absolutely one of the most anchoring truths in both caring for cancer patients and being cared for is patient autonomy.

Often in the book, you will hear me use the expression that the patient is the one with the disease. In the final analysis, after all the health care system can do to make information and access to care available, the final decision of the competent adult is theirs. That is how it should be and physicians, families, and patients must never forget it.

Listen to how beautifully American judges state this. “No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestionable authority of law [Union Pacific R. Co. vs. Botsford, 141 U.S. 250 (1891)].

Here is another ruling that clearly distills it down on the issue of medical decision-making. “Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits assault, for which he is liable in damages [Schloendorff vs. Society of New York Hospital, 105 N.W. 92 (1914)].

Thus, patient autonomy refers to the capability and right of patients to control the course of their own medical treatment and participate in the treatment decision-making process.

Indeed! That is also a core guiding principle of this book. Repeatedly in this book, you will see that physicians and their teams must fully inform their patients to the best their ability and the best of the patients’ ability to understand. Health care providers lead the patient to intelligence. However, it is the patient’s job, once lead, to think. As you will hear repeatedly, the patient is the one with the disease.

Why keep hammering this home? God gave you the gift of choice and the greater gift of sufficient intelligence to make those choices if you are sufficiently informed. That is exactly what this book is attempting to do; inform. That is why this section appears early on. Patients must know the power they rightfully can claim. So empowered , they will be able to transform the pain of anxiety, which is fear of the unknown , into the hero producing powers behind fear which are a God given hard wired set of emotional, physical and intellectual responses that can and do lead us to wise, autonomous personal decisions

Therefore, once one is an autonomous patient, we must inform ourselves about some of the key players and passions and emotions and events as one moves from tumor being the rumor to cancer being the answer that will be dealt with by our personal health care team.

Furthermore, we will now look at the nature of anxiety versus fear, the persona of cancer, so to speak, some operational details of the world of oncology and finally the persona of the your major ally in the fight, your oncologist. Then we can jump in together, arm and arm with hearts, heads and minds aligned and learn what to do When Tumor Is the Rumor and Cancer Is The Answer. FROM THE BOOK



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