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Nursing Ethics
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The Principle of Respect for Autonomy in the Care of Nursing Home Residents

Ghislaine JMW van Thiel

Utrecht University, Utrecht, The Netherlands, Gvthiel{at}theo.uu.nl

Johannes JM van Delden

Utrecht University, Utrecht, The Netherlands

Respect for autonomy is well known as a core element of normative views on good care. Most often it is interpreted in a liberal way, with a focus on independence and self-determination. In this article we argue that this interpretation is too narrow in the context of care in nursing homes. With the aim of developing an alternative view on respect for autonomy in this setting we described four interpretations and investigated the moral intuitions (i.e. moral judgements) of caregivers regarding these approaches. We found that these caregivers seemed to value different notions relating to respect for autonomy under different circumstances. There was no significant difference in moral judgements between men and women or between doctors and nurses. We conclude that a multidimensional understanding of this principle would best fit this context. We end this article with a description of a modest theory of respect for autonomy in nursing homes.

Key Words: autonomy • care • ethics • nursing homes

Nursing Ethics, Vol. 8, No. 5, 419-431 (2001)
DOI: 10.1177/096973300100800506
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