Patient Autonomy, Paternalistic Healthcare Providers, and Criminal Liability in Therapeutic Contracts

Abstract

This study examines the status of patient autonomy and the limits of healthcare professionals’ paternalism within therapeutic contracts, as well as the potential for criminal liability arising from violations of patients’ rights under positive law. Employing normative legal research with statutory and conceptual approaches, it analyzes primary legal materials in the form of legislation and court decisions, alongside secondary legal materials comprising doctrinal writings and scholarly literature, through a qualitative and prescriptive method. The findings indicate that therapeutic contracts position patients simultaneously as legal subjects and as parties who, in factual terms, occupy a vulnerable position, thereby creating space for the dominance of healthcare professionals. Patient autonomy is normatively guaranteed through provisions on informed consent in health regulations and medical practice laws; however, this has not been accompanied by the formulation of specific criminal offenses that explicitly criminalize violations of consent to medical interventions. Paternalistic conduct by healthcare professionals is still permitted in emergency situations, provided that it aims to protect patient safety and is carried out in accordance with professional standards. The absence of clear criminal provisions results in the protection of patient autonomy relying largely on civil, ethical, and administrative mechanisms, which do not yet provide a sufficiently deterrent effect. The study recommends the establishment of explicit prohibitory norms regarding medical interventions without valid consent, applicable to all healthcare professionals, alongside a clear affirmation of informed consent as an integral component of professional standards and standard operating procedures. Furthermore, a reinterpretation of the therapeutic relationship as an obligation of best efforts grounded in equitable communication is essential to balance the need for prompt medical intervention with respect for patient autonomy, so that every clinical decision reflects the outcome of rational consent rather than mere professional dominance that may cause physical or psychological harm to patients.