Article

A common source of ethical challenge for health care professionals
(HCPs) in rehabilitation is situations when patients wish to make risky choices
not related or contrary to rehabilitation goals. We explore the potential
contribution of a relational understanding of autonomy for orienting clinical
practice when patients wish to enact choices with associated risks for the
patient or others. METHOD: We provide a theoretical analysis that is oriented by
an examination of risk and a relational conception of autonomy, as relevant to
rehabilitation care. We illustrate our analysis through the examination of a
clinical case. RESULTS: Relational autonomy assumes that the patient, and the
patient's decisional autonomy, is situated and shaped by relationships. From this
perspective, HCPs can engage in a process of communication and deliberation with
the patient about the risky choices at issue, leading towards improved patient
autonomy. CONCLUSIONS: Relational autonomy can contribute to understanding
patients' risky choices and guiding HCPs as they partner with patients towards
autonomy. Such an approach supports patient-centred rehabilitation care.
Ultimately, as clinicians respond to a patient who wishes to enact a risky
choice, they should aim for a partnership towards autonomy with the patient and
family.

Langue : ANGLAIS