• Western University

• HS 2610

Susan Sherwin’s Relational Approach to Autonomy in Health Care p34-43
A feminist analysis of autonomy
 Feminist approach
o an approach that looks at all people and particular focuses on inequities
and the issues of oppressed people (by gender, race, social class, etc)
 Relational
o Relating to everything around it, aka. socially situated or contextualized
o Unlike Carol Gilligan who refers to “relations” as personal, this is the
multiple relations in society
Problems With the Autonomy Deal
 We must question how much control patients actually have in deciding their
healthcare treatment
 Giving informed consent treatment before receiving/declining is supposed to
guarantee patient autonomy
 But, in practice, the actual procedures used to obtain consent do not protect
patient autonomy
o Problems of physician time and $, doctor communication skills and
cultural differences
 But there is a deeper problem:
o The model that informed consent is built on is a model of articulate,
intelligent patients who are use to making decisions about their life path
and possess necessary resources to have a wide range of options to choose
among
 Eg. Built off upper-middle class man who’s money/situation allows
him to have multiple viable options for treatment
 Autonomy often (and wrongly) understood to be opposite of and outweighing all
other moral values, especially justice
o Because autonomy interpreted as “freedom from interference”