Reframing patient-doctor relationships: Relational autonomy and treating autonomy as a virtue

Elaina Gauthier-Mamaril* (Corresponding Author)

*Corresponding author for this work

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Despite extensive theoretical debate, concrete efforts to overcome paternalism and unbalanced power relations between patients and doctors have produced limited results. In this article, I examine and build on the concept of relational autonomy to reframe the patient-doctor relationship. Specifically, I argue for an alternate form of autonomy anchored in Spinozism that recognises the relation between rationality and affectivity and moves away from the model of Cartesian dualism. I then use Filipino conceptions of individuality to explore treating autonomy as a systemic virtue, where ‘virtue’ is understood as a strength that requires support from systems of agency. In other words, autonomy as a systemic virtue is a practice of focusing on one’s power of acting that is sustained by supportive relationships between individuals and social institutions.

Original languageEnglish
Pages (from-to)32-47
Number of pages16
JournalJournal of Global Ethics
Issue number1
Early online date2 Jun 2022
Publication statusPublished - 2022

Bibliographical note

I would like to thank my peer reviewers as well as co-editors of this special edition for their constructive comments that have helped me streamline and strengthen my argument.


  • relational theory
  • medical humanities
  • Ethics
  • autonomy
  • para-rationality
  • affectivity
  • relational autonomy
  • Feminist bioethics
  • feminist relational theory
  • paternalism
  • individuality
  • virtue


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