There is a range of ethical, legal and professional issues associated with end of life care and the decisions made by healthcare professionals. The complexity of such decisions may lead healthcare professionals to question whether they have fulfilled their ethical, legal and professional duties towards the patients they care for. Respect for the ethical principle of autonomy and an understanding of the law may assist in mitigating any doubts that healthcare professionals have about fulfilling these duties. This article examines the ethical principle of autonomy and how it relates to advance decisions to refuse treatment, do not attempt cardiopulmonary resuscitation orders and the doctrine of double effect. It also outlines the relevant legal guidance regarding autonomy and end of life care decisions.

Lisbeth Bourne at the time of writing was co-programme leader, Children and Young People and Mental Health Nursing, School of Health and Society, University of Salford, Salford, England