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Limits to relational autonomy--the Singaporean experience.
Lalit Kumar Radha Krishna1, Deborah S Watkinson2, Ng Lee Beng3
1National Cancer Center Singapore, Singapore lalit.krishna@nccs.com.sg.
Nursing Ethics
|June 11, 2014
Summary
In Singapore, relational autonomy in healthcare decision-making is limited by family-centric norms. An authoritative, welfare-based approach is proposed to better meet care needs, respecting personhood beyond family ideals.
Area of Science:
- Bioethics
- Medical Sociology
- Healthcare Policy
Background:
- The Principle of Respect for Autonomy faces challenges in family-centric societies like Singapore.
- Relational autonomy has been proposed as an alternative framework for healthcare decision-making.
- Empirical data from Singapore reveals limitations of relational autonomy due to cultural and societal factors.
Purpose of the Study:
- To evaluate the applicability of relational autonomy in Singapore's healthcare context.
- To explore patient, family, and healthcare professional perspectives on decision-making.
- To propose a new framework for healthcare decision-making in Singapore.
Main Methods:
- Analysis of empirical data on patient and family opinions in Singapore.
- Examination of healthcare professional practices within a Confucian-inspired context.
- Review of Western concepts of autonomy and their limitations in local settings.
Main Results:
- Relational autonomy shows limitations in bridging family norms and Western autonomy concepts.
- Limited evidence of a shift towards individual decision-making despite Western influence.
- Psychosocial and cultural factors significantly impact decision-making, challenging "content neutral" assumptions.
Conclusions:
- The application of relational autonomy is hindered by cultural and structural factors in Singapore.
- Existing models fail to adequately address complex psychosocial and cultural influences on decision-making.
- An authoritative, welfare-based approach within best interest decision-making is proposed to address current care needs.
Keywords:
End of lifeRing Theory of Personhoodmultidisciplinary teampalliative carepersonhoodrelational autonomywelfareMore Related Videos
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