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The reason it is disabled by default is two fold.
1. If it is enabled, that pawn would start to self tend as soon as they were undrafted after a fight and this would result in bad tending when you'd prefer your actual capable doctor to do it for them.
2. if your doctor himself is hurt or has reduced capability to manipulate objects (happens when your arm is shot or stabbed) they will suck at tending to themselves as well. So it is better to have another medical capable pawn tend for them.
Other than that, what woodiestmink says is true, even if self tending is enabled a pawn won't autonomously tend themselves unless they're also assigned as a doctor, and with a higher priority than other jobs in need of doing.
This is excellent advice. And if it doesn't show you exactly why it doesn't work it will at least give you a good idea of what it could be.
At skill 5 the self tending effectiveness would be very low, but may be necessary to stop them bleeding in time.
Not quite, but once the bleeding is stopped and they're resting in the hospital you have a chance to let your proper doctor do the next set of tending (for diseases mostly). Once they're patched they're good to heal, no "fresh bandages" needed unless you mod it in.