Coming to terms with chronic illness: the negotiation of autonomy in rheumatoid arthritis

This paper examines ways in which daily life is sustained in the face of chronic illness. Using data from interviews with people with rheumatoid arthritis, we try to capture the complexity of the interdependence between individuals with chronic illness and society. The main areas focused on cover the disordered body, disruption of relationships, and management of a deviant identity. What emerges is the relativities in everyday negotiations involved as people assimilate or come to terms with the circumstances of disablement. A great deal of research by rehabilitation specialists and advocates of independent living makes use of an abstract notion of the individual and a categorical definition of independence. We suggest that through the subtle relativities individuals in fact sustain considerably more self-determination than is suggested by prevalent notions of independence. This state of affairs is more appropriately referred to as autonomy. The implications of this perspective for health care professionals are discussed.