Respect du droit et de l'autonomie ou bienfaisance ?

Based on an analysis of a clinical case where a resident of a medicosocial facility refused to accept neuroleptic treatment, we discuss the issues raised by changing laws which place greater focus on the patient's right of independence. The questions examined concern a conflict between the respect of anticipated directives (art. 23a,b Vandoise Law on Public Health) and benevolence. The problem occurs mainly when directives, expressed by the patient, are in opposition with the only therapy currently available, and thus compromise the patient's well-being. The physician is faced with a dilemma opposing strict application of the law and the duty of benevolence.