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Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

Abstract:
The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person’s care and responsibility for connected others.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1177/1477750917704156

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Population Health
Role:
Author
More by this author
Role:
Author
ORCID:
0000-0002-9006-3157


Publisher:
SAGE Publications
Journal:
Clinical ethics More from this journal
Volume:
12
Issue:
3
Pages:
150-165
Publication date:
2017-04-13
DOI:
EISSN:
1758-101X
ISSN:
1477-7509
Pmid:
28989327


Language:
English
Keywords:
Pubs id:
pubs:731328
UUID:
uuid:093935a6-3d49-4b4e-8951-d27219d83a9a
Local pid:
pubs:731328
Source identifiers:
731328
Deposit date:
2019-04-02

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