Autonomy means that an individual is self-governing, or that they are able to make their own choices without being controlled by anyone else. In healthcare, this would mean that the individual would be able to hold different ethics than the healthcare system treating them. For example, someone who is ill and needs a blood transfusion might decline this treatment due to religious reasons. Ethically, a doctor may not wish to follow the patient's wishes beause they may die from refusing treatment. Therefore, autonomy means that health care workers have their ethical principles affected by factors including the patient's wishes, confidentiality, informed consent, truth telling, and promise keeping.