To have autonomy is to have the ability to ‘self-govern’ or make choices that guide one’s life path.
For instance, if I am coerced (e.g. someone threatens my life) or if I act merely based on what makes me happy in the moment (e.g. eating a whole pint of ice cream), then I have acted heteronomously rather than autonomously. This is because my actions are caused by emotions or things external to me.
A relational understanding of autonomy takes individuals to be constantly situated in historical and social contexts (e.g. socio-economic status, race, gender, ability, etc.). These social components are fundamental to individual identity and comprise a web through which choosing one’s path may be more or less possible, intelligible, and supported.
Whether or not a patient has the capacity to make decisions, healthcare decisions (like all decisions) are typically shared or relational. We depend on others to help us make decisions that are in our best interest. Clinicians play a significant role in this process.
- Sherwin, S. A Relational Approach to Autonomy in Health Care, In The Politics of Women’s Health, Philadelphia, Temple University Press.