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|DOI (Digital Object Identifier) Link:||http://dx.doi.org/doi:10.1111/j.1365-2753.2012.01915.x|
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The practice of offering choice to those women with breast cancer for whom either breast conserving surgery or mastectomy would be equally beneficial, has come to be seen as an important aspect of medical care. As well as improving satisfaction with treatment, this is seen as satisfying the ethical principle of respect for autonomy. A number of studies, however, show that women are not always comfortable with such choice, preferring to leave treatment decisions to their surgeons. A question then arises as to the extent that these women can be seen as autonomous or as exercising autonomy. This paper argues, however, that the understanding of autonomy which is applied in current approaches to breast cancer care does not adequately support the exercise of autonomy, and that the clinical context of care means that women are not able to engage in the kind of reasoning that might promote the exercise of autonomy. Where respect for autonomy is limited to informed consent and choice, there is a danger that women’s interests are overlooked in those aspects of their care where choice is not appropriate, with very real, long term consequences for some women. Promoting the exercise of autonomy, it is argued, needs to go beyond the conception of autonomy as rational individuals making their own decisions, and clinicians need to work with an understanding of autonomy as relational in order to better involve women in their care.
|Item Type:||Journal Article|
|Copyright Holders:||2012 Blackwell Publishing Ltd|
|Keywords:||autonomy; breast cancer; treatment choice|
|Academic Unit/Department:||Health and Social Care|
|Depositing User:||Mary Twomey|
|Date Deposited:||21 Nov 2012 16:06|
|Last Modified:||21 Nov 2012 18:31|
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