Autonomy is a key principle in biomedical ethics, giving patients the right to be involved in their own care. Professional autonomy allows paramedics to make critical decisions around patient care in an emergency, enabling them to provide life-saving treatment. A patient's autonomy can conflict with that of a paramedic, leading to complex ethical challenges, which can affect the way a paramedic performs their duty of care. An autonomous patient has the right to refuse treatment, creating ethical challenges for paramedics. An autonomous patient's decision to refuse treatment, even if it may seem unwise, must be respected in accordance with the Human Rights Act 1998.