Autonomy As A Goal of Patient Education What Are the Goals of Patient Education?
The primary goal of patient education should be to empower patients to make autonomous decisions about their health, rather than merely encouraging them to follow the doctor’s orders. This represents a significant departure from traditional models of patient education, which have historically focused on compliance with medical advice.
Supporting patient autonomy requires healthcare professionals to approach patient education without the expectation of simply reinforcing a physician’s directives. This shift calls for a collaborative and patient-centered approach, where the goal is to equip patients with the knowledge, skills, and confidence needed to make informed decisions that align with their personal values and health goals.
Autonomy in patient education implies:
- Providing comprehensive information that helps patients understand their health condition.
- Offering a range of treatment options, rather than limiting choices to what the physician deems best.
- Fostering a sense of control and empowerment in patients, enabling them to make health decisions confidently.
To achieve this, health professionals must move beyond the traditional model of patient education, which often emphasized compliance, and embrace a model that centers on informed decision-making and patient empowerment.
Autonomy as a Goal for Patient and Health Education in Nursing
True patient-centered education often involves challenging physician and institutional practices, limitations in medical knowledge, and even clinical judgments that mask rationing of care. However, true autonomy for patients goes beyond the right to refuse treatment. It involves creating meaningful options that address individual patient needs and values.
Autonomy is more than just informed consent—it should be woven into every patient interaction. An autonomous patient can make decisions with a sense of control and agency, carefully evaluating their options based on personal preferences, values, and attitudes. Autonomy also involves reflecting on how these factors influence decision-making processes.
One of the most compatible views of autonomy for patient education is Diana Meyers’ (1989) theory of autonomy competence, which consists of several key skills:
- Self-discovery: Understanding one’s own preferences, values, and health goals.
- Self-direction: The ability to guide one’s decisions and actions in alignment with those values.
- Self-definition: The capacity to define oneself and one’s goals independently of external pressures.
These skills may vary in their development and application, but a competent and autonomous patient should be able to exercise and coordinate them effectively.
The Role of Socialization in Autonomy
Certain socialization processes can encourage the development of autonomy in some areas while inhibiting it in others. For example, traditional gender norms often compromise women’s ability to fully achieve autonomy. These norms may lead women to doubt their ability to make health decisions confidently, especially in matters like pregnancy, where societal expectations place the entire responsibility for outcomes on women (Mackenzie & Stoljar, 2000; McLeod, 2002).
When patient education reinforces these oppressive social norms, it limits autonomy. Another example of a limiting norm is the dismissal of patients’ bodily knowledge as valid clinical evidence. This is common among socially marginalized groups, who may not be considered credible in their accounts of their health experiences.
Ignorance as an Obstacle to Autonomy
Ignorance is one of the primary barriers to patient autonomy. When healthcare professionals and systems allow patients to remain uninformed about their conditions, treatments, and options, they contribute to an oppressive dynamic. Patients who leave healthcare interactions feeling incapable of making their own decisions often have no choice but to defer to the authority of the doctor. This dynamic is particularly pronounced for patients from lower socioeconomic backgrounds, who are often reduced to their medical condition in the eyes of the healthcare system. Meanwhile, those from higher socioeconomic classes may retain their full identity outside of their disease.
This phenomenon is part of a broader pattern of social oppression. When a group is oppressed, society often views them as less competent or valuable, which in turn leads individuals within the group to internalize these attitudes. This internalized oppression can make it even more difficult for individuals to assert their autonomy and make independent decisions (McLeod & Sherwin, 2000).
The Energy Required to Resist Oppression
It takes significant energy to resist societal norms and assert one’s autonomy, especially in the face of longstanding stereotypes or dominant interests. For many patients, it is easier to conform to the expectations placed on them, even if doing so diminishes their autonomy. This dynamic is deeply entrenched in healthcare, where the traditional framework often sets patients up to passively accept medical advice rather than engage in autonomous decision-making.
Challenges to Patient Autonomy in Healthcare
The traditional healthcare model, with its emphasis on disclosing physician-recommended treatments, often limits patients’ ability to perceive the full range of their options. This can be seen as a form of paternalism, where healthcare professionals tailor the information provided to ensure patients select the treatment that the physician believes is best (McLeod & Sherwin, 2000).
This indirectly paternalistic approach is problematic because it:
- Limits patient autonomy: By restricting the information shared with patients, healthcare professionals reduce the range of options patients can realistically consider.
- Reinforces power imbalances: When healthcare professionals act as the ultimate authority on treatment decisions, patients are left with little choice but to follow medical advice.
- Excludes non-dominant groups: Research on health issues that disproportionately affect marginalized groups is often lacking, further diminishing the options available to these patients.
Addressing these challenges requires a fundamental shift in how healthcare professionals approach patient education. Rather than assuming a position of authority, they must engage with patients as partners, providing the information, resources, and support needed to empower patients to make decisions that reflect their values and priorities.
Conclusion
Autonomy should be the central goal of patient education in both healthcare and nursing. Achieving this goal requires a transformation in how healthcare professionals interact with patients—moving from a compliance-based model to one that fosters informed decision-making and patient empowerment. By supporting autonomy, healthcare providers not only improve patient outcomes but also promote a more equitable and patient-centered healthcare system.
Educating patients to make autonomous decisions involves more than providing information. It requires creating a range of meaningful options, respecting patients’ bodily knowledge, and challenging oppressive norms that limit decision-making. Ultimately, autonomy in healthcare is about enabling patients to take control of their health in ways that align with their unique values, beliefs, and life circumstances.