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End-of-life ethics

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

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

Open access · cc by · source: Europe PMC

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.

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.

Key findings

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.

Methodology

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.

Limitations

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

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsEnd-of-life ethicsconcept

    Respect for autonomy remains central at the end of life, but decisions are better understood relationally in clinical context than as isolated choice characteristics.

    Evidence for the claim as stated.

  • SupportsEnd-of-life ethicsconcept

    Relational-autonomy authors keep autonomy central; comparative statute work shows jurisdictions that still lack a forgoing-LST law or treat family as the decision site.

    Evidence for the claim as stated.

  • Applied to autonomy, the method adds bodily and affective engagement to the deliberative picture. One paper argues that the Mental Capacity Act's understand-retain-use-weigh test omits affective and bodily intentional capacities that are necessary components of autonomy, not extras; another argues that Beauchamp and Childress's account of autonomy as a property of decisions is too thin for end-of-life care, where decisions are better understood relationally and in clinical context.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    Relational-autonomy authors keep autonomy central; comparative statute work shows jurisdictions that still lack a forgoing-LST law or treat family as the decision site.

    Also on this tension

Related papers in this topic

Same topic cluster — not a recommendation engine.