Why Worry about Autonomy?

Twomey, Mary (2015). Why Worry about Autonomy? Ethics and Social Welfare, 9(3) pp. 255–268.

DOI: https://doi.org/10.1080/17496535.2015.1024154


Ethics is an important part of the curriculum for students of health and social care, and teaching about autonomy occupies a central place in that curriculum. This paper argues, however, that the approach to autonomy that is taken in several of the current texts which support such teaching is unhelpful to future practitioners and to service users. Current teaching about autonomy can result in ‘checklist ethics’, and a reliance on independent decision-making by reasonable adults, and which is exercised through informed consent and a narrow set of choices. This is an approach which can undermine rather than promote the exercise of autonomy in some cases, particularly if the way in which some service users express autonomy is not recognised or if health and social care practitioners are unable to relate ethical principles to their own practice. An approach to teaching which emphasises relational autonomy, and encourages students to understand the contexts of care that they are likely to encounter in practice, will emphasise the role of the practitioner in promoting autonomy and the exercise of autonomy rather than independent decision-making by reasonable adults.

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