Abstract
Patient autonomy is the foundational moral principle of healthcare. In this chapter, I review how autonomy has been conceptualized in the medical field and compare that with understandings of autonomy discussed in design. I argue that patient autonomy in healthcare has mainly been understood as negative freedom—independence from the interference of others, especially medical paternalism. Therefore, patient autonomy has been conceptualized as decision-making and has been applied to practice as a procedural means to cure rather than an end in itself. In contrast, user autonomy in design highlights positive freedom—the elevated state of one’s ability to govern one’s own life according to an internal will. Therefore, autonomy in design has been construed more broadly as a concept that encompasses thoughts, decisions, and actions, and has been seen as an end in itself. The collaboration of healthcare professionals and designers allows for productive opportunities to holistically support patients and their caregivers, as this collaboration brings together autonomy as means and autonomy as ends. I conclude the chapter by proposing that the study of autonomy as a guiding principle is essential in expanding healthcare service design to consider diverse agents.
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Kim, M. (2023). Patient Autonomy and User Autonomy in the Ecology of Care. In: Pfannstiel, M.A. (eds) Human-Centered Service Design for Healthcare Transformation. Springer, Cham. https://doi.org/10.1007/978-3-031-20168-4_9
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