The principle of autonomy is widely recognized to be of utmost importance in bioethics; however, we argue that this principle is often misapplied when one fails to distinguish two different contexts in medicine. When a particular patient is offered treatment options, she has the ultimate say in whether to proceed with any of those treatments. However, when deciding whether a particular intervention should be regarded as a form of medical treatment in the first place, it is the medical community who has the ultimate say. Some argue that particular interventions should be allowed by virtue of the fact that they are autonomously requested. But making such an argument fails to distinguish between these two contexts and misapplies the principle of autonomy, ultimately having the potential to instigate problematic changes in the practice of medicine.

自主原则在生物伦理学中被广泛认为是最重要的；然而，我们认为，当人们无法区分医学中的两种不同情况时，这一原则往往会被误用。当向特定患者提供治疗选择时，她对是否继续进行任何治疗有最终决定权。然而，在决定某项干预措施是否应首先被视为一种医疗形式时，医学界拥有最终发言权。一些人争辩说，由于它们是自动请求的，因此应该允许特定的干预。但是提出这样的论点无法区分这两种情况，并且误用了自主原则，最终有可能在医学实践中引发有问题的变化。