The virtue of moral responsibility and the obligations of patients.

The American Medical Association has provided a list of patient responsibilities, said to be derived from patient autonomy, without providing any justification for this derivation. In this article, the virtue of moral responsibility is proposed as a way to justify these kinds of limits on respect for individual autonomy. The need for such limits is explained by examining the traditional principles of health care ethics. What is missing in health care decision making, and can be provided by the virtue of moral responsibility, is a careful consideration of the impact of individual decisions on particular others and the community, as a whole. The concept of moral responsibility as a virtue is then developed and examples of its application to health care decision making are provided. Finally, the roles of both physicians and health care ethicists in promoting the morally responsible exercise of individual autonomy are explored.