European Court of Human Rights Practice on Violation of Patient Autonomy as an Ethical Principle in Medicine

Patient autonomy is an important right both legally and ethically for making sound choices concerning one's healthcare treatment. It is a key component of medical ethics and is protected by international human rights laws such as the European Convention on Human Rights (ECHR). However, despite well-established legislation, numerous violations of patient autonomy persist in Europe's healthcare system. This study analyzes the jurisprudence of the European Court of Human Rights (ECtHR) on the infringements of patients' right to autonomy and the Court's application of Articles 3, 8, and 9 of the ECHR. Doctrinal legal research was carried out by analyzing Grand Chamber and Chamber judgments of the ECtHR from 2011 to 2026, covering landmark cases from Spain, Ukraine, and Poland concerning emergency surgeries, advance directives, prenatal diagnosis, and the scope of surgical consent. Four notable cases indicate four types of autonomy violations: (1) healthcare professionals' failure to adhere to valid advance directives (Pindo Mulla v. Spain, 2024); (2) lack of regulations regarding emergency consent (Mayboroda v. Ukraine, 2023); (3) refusal to provide diagnostic information as a result of discrimination (R. R. v. Poland, 2011); and (4) performing surgeries beyond consent provided by patients (S. O. v. Spain, 2025). The Court has firmly established that patients' particular refusals prevail over professional decision-making, converting the ethical aspiration of patient autonomy into a legal right. Advance directive registration, emergency communication measures, and consent-specific training programs are needed. These standards apply not only to EU member countries but to all signatories to the Convention.