<P> Since the 1960s, there have been attempts to increase patient autonomy including the requirement that physician's take bioethics courses during their time in medical school . Despite large scale commitment to promoting patient autonomy, public mistrust of medicine in developed countries has remained . Onora O'Neill has ascribed this lack of trust to medical institutions and professionals introducing measures that benefit themselves, not the patient . O'Neill claims that this focus on autonomy promotion has been at the expense of issues like distribution of healthcare resources and public health . </P> <P> One proposal to increase patient autonomy is through the use of support staff . The use of support staff including medical assistants, physician assistants, nurse practitioners, nurses, and other staff that can promote patient interests and better patient care . Nurses especially can learn about patient beliefs and values in order to increase informed consent and possibly persuade the patient through logic and reason to entertain a certain treatment plan . This would promote both autonomy and beneficence, while keeping the physician's integrity intact . Furthermore, Humphreys asserts that nurses should have professional autonomy within their scope of practice (35 - 37). Humphreys argues that if nurses exercise their professional autonomy more, then there will be an increase patient autonomy (35 - 37). </P> <P> The Yogyakarta Principles, a document with no binding effect in international human rights law, contend that "self - determination" used as meaning of autonomy on one's own matters including informed consent or sexual and reproductive rights, is integral for one's self - defined or gender identity and refused any medical procedures as a requirement for legal recognition of the gender identity of transgender . If eventually accepted by the international community in a treaty, this would make these ideas human rights in the law . The Convention on the Rights of Persons with Disabilities also defines autonomy as principles of rights of a person with disability including "the freedom to make one's own choices, and independence of persons". </P> <P> A study conducted by David C. Giles and John Maltby conveyed that after age effecting factors were removed a high emotional autonomy was a significant predictor of celebrity interest, as well as high attachment to peers with a low attachment to parents . Patterns of intense personal interest in celebrities was found to be conjunction with low levels of closeness and security . Furthermore the results suggested that adults with a secondary group of pseudo-friends during development from parental attachment, usually focus solely on one particular celebrity, which could be due to difficulties in making this transition . </P>

The freedom to make your own decisions auto