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

ABSTRACT 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.