When aid is a good thing: trusting relationships as autonomy support in health care settings

Decision making in health care contexts is often deeply challenging for the patients, their close ones, and those who care for them. All of them have and perceive different forms of responsibilities, with each of them seeking the best for the patient. The demands and scope of informed consent have increased in health care settings. At the same time, the vulnerabilities und insecurities of patients require a perspective that goes beyond questions about the right to choose without coercion or deception. Finding the optimal balance between respecting individual autonomy and circumventing individual autonomy for the benefit of the patient is challenging for those concerned and their caregivers and family members. In the pursuit of shaping patients' choices while preserving their freedom to choose, the role of nudges in health care is an ongoing matter of debate (Blumenthal-Barby and Burroughs 2012; Cohen 2013; and see the respective discussions in those issues).