The Self-Determination Act, enacted in 1991, emphasizes what principle in health care decisions?

• A. Autonomy
• B. Confidentiality
• C. Licensing
• D. Scope of practice

Answer: (A)

Autonomy is the guiding principle here. The Self-Determination Act requires health care facilities to inform patients about their rights to participate in decisions about their care and to establish advance directives. It centers on the patient’s control over medical choices, including the ability to consent to or refuse treatment and to have those preferences respected, even if the patient’s ability to communicate later changes. This emphasis on self-governed decision-making, rather than on privacy of information (confidentiality), regulatory licensing, or the boundaries of professional practice (scope of practice), is what the act is designed to safeguard.