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Is end-of-life autonomy only an isolated choice?

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The authors treat respect for autonomy as central at the end of life but argue decisions are better understood relationally, in clinical context, not as isolated characteristics of a choice.

Source

Relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities

Gómez-Vírseda C, de Maeseneer Y, Gastmans C · BMC medical ethics · 2020

doi.org/10.1186/s12910-020-00495-1Read the full paper ↗83 citationscc by

Study at a glance

Design
Other — Relational-autonomy ethics for end-of-life decisions, illustrated with a clinical vignette
N
Normative clinical ethics; vignette is illustrative, not a sample N
Population
End-of-life and palliative shared decision-making about respecting autonomy
Outcome
Autonomy as relational and contextual rather than an isolated property of a choice

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

They start from Beauchamp and Childress, note relational autonomy’s role in palliative care and shared decision-making, present a positive account mixing ethical approaches, and use a clinical vignette (distant sister, unconscious patient) to show real-life complexity.

What they found

A contextualised approach is needed to meet clinical complexities. End-of-life decision-making is better understood when social relations are taken into account. Autonomy as a property of decisions (Beauchamp–Childress) is too thin.

The limits

What it doesn't show

This is a conceptual ethics paper, not a new hospice trial. The vignette is illustrative.

Key terms

Respect for autonomy
Key principle in contemporary medical ethics, especially prominent in end-of-life debates.
Relational autonomy
Autonomy as constituted in relationships, proposed as foundational in palliative/shared decisions.
Decision-autonomy
Beauchamp and Childress-style view of autonomy as a characteristic of decisions rather than persons-in-relation.
Contextualised approach
An account meant to meet real-life clinical complexities rather than idealised isolated choosers.

Flashcards

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Quiz yourself

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At end of life, the prominent principle is often?

Common questions

What is their positive account?

Relational autonomy incorporating elements of different ethical approaches.

What is too thin?

Treating autonomy only as a characteristic of decisions.

Why context?

To meet real-life complexities in clinical practice.

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