Relational autonomy: moving beyond the limits of isolated individualism

Title

Relational autonomy: moving beyond the limits of isolated individualism

Creator

Walter JK; Ross LF

Publisher

Pediatrics

Date

2014

Subject

adolescent; Child; Female; Humans; Male; Adolescent Psychology; Personal Autonomy; Physician-Patient Relations; Pediatrics; Parents; Withholding Treatment; Professional-Family Relations; Communication; Child Psychology; Palliative Care; Psychological; Models

Description

Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.
2014-02

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

S16-23

Volume

133 Suppl 1

Citation

Walter JK; Ross LF, “Relational autonomy: moving beyond the limits of isolated individualism,” Pediatric Palliative Care Library, accessed July 26, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14894.

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