The deficiency of liberal autonomy in mental healthcare settings
Date
2018
Authors
Joannou, Simone Lee
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Abstract
Patients’ experiences of vulnerability in the clinical encounter are a decisive factor in how they respond to their diagnoses and whether or not they will proceed with treatment. This experience of vulnerability is not adequately accounted for in the standard model of the doctor-patient relationship that currently dominates medical ethics. The model of doctor-patient relationships has come to resemble closely the consumer-provider relationship model in liberal Western culture, and as a result clinical encounters have come to look more like business transactions, which treat patients as primarily consumers. Ultimately, this results in a clinical encounter relationship that undermines patient autonomy, revealing a problem inherent in the way that physicians understand individual autonomy. I argue that the failure to address patient vulnerability adequately in the clinical encounter amounts to a failure to respect patient autonomy, and that this problem may be attributed to an outdated and simplistic account of autonomy that informs standards for doctor-patient relationships. Such an account of autonomy addresses only the competency conditions of autonomy and neglects the authenticity conditions of autonomy. I conclude that an updated and more nuanced account of autonomy, which provides strong authenticity conditions as well as competency conditions, will consequently bolster the standard of doctor-patient relationships, and in turn afford patients a greater level of autonomy with which to make sound decisions regarding medical treatment.
Description
A research report submitted to the Wits Department of Philosophy, Faculty of Humanities, University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Arts in Philosophy by combination of coursework and research report.
Johannesburg, 2018
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Citation
Joannou, Simone Lee (2018) The deficiency of liberal autonomy in mental healthcare settings, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/26614>