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Does shared decision making respect a patient's relational autonomy?
Author(s) -
Lewis Jonathan
Publication year - 2019
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13185
Subject(s) - autonomy , consistency (knowledge bases) , interpersonal communication , psychology , social psychology , interpersonal relationship , political science , computer science , law , artificial intelligence
According to many of its proponents, shared decision making (“SDM”) is the right way to interpret the clinician‐patient relationship because it respects patient autonomy in decision‐making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues that standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy.