The patient as a citizen. Patient’s autonomy and civic virtue as seen in Spain

Abstract

The paper focuses on the changing perception of bioethics and the patient’s autonomy in Spain where paternalism and  Catholic  Church teachings  shaped relationships between  physicians and patients for many long years. The country’s political transformation following the collapse of Francisco Franco’s dictatorship (1936–1975) has also brought major changes on matters of bioethics. The growing sense of civic virtue has enhanced the importance of the patient’s autonomy in medicine. This manifests itself on several levels: in legislation (law on patient’s autonomy), in the social field (NGOs operating in medical care), in growing awareness of patients’ rights and critical approach to relations with medical professionals) as well as in ideology (criticism of paternalism, civic bioethics, disapproval of commercialization in medicine). Moreover, the specificity of the current situation in Spain is also determined by a re-evaluation of the Catholic Church’s heritage and abandonment of its teachings in civic bioethics and consequently, by liberalization of the abortion law as well as enactment of legal regulations  on assisted reproduction, pre-implantation genetic diagnosis and embryo research.