It is an established legal and ethical principle that healthcare practitioners must respect a patient’s right to autonomy. However, clinicians may sometimes find this difficult for various reasons. Patients may be unable or unwilling to contribute to decisions about their care, and practitioners can find it difficult to accept some of the decisions patients make, particularly if they appear unwise or even irrational.

A lack of understanding of the law may contribute to the challenge of balancing an obligation to provide care. This article discusses the legal basis of patient autonomy and considers how this theory can be applied in practice. Part 2, in the next issue of Primary Health Care, will explore a range of situations in which practitioners may find respecting an adult patient’s right to autonomy challenging. Opportunities to reflect on practice are presented.