Beyond Consent: Self-Determination and Protecting High-Risk Patients in Health Care

Abstract

Modern healthcare is built on the principle of informed consent which is the basis of patient autonomy and self-determination. However, this model has its very clear limits when applied to high-risk and vulnerable patients whose decision-making capacity is impaired. This study examines what lies behind consent in healthcare and asks how legal systems can protect high-risk patients without undermining their dignity, agency and human rights. The analysis adopts a comparative legal approach. It relies on international instruments and national examples from diverse legal traditions. The article argues that vulnerability should not serve as a justification for paternalism or uncontrolled coercion. Going beyond consent does not mean abandoning autonomy, it means reconceptualizing it in a way that ensures self-determination and protection for those most vulnerable in health care systems.