Developing New Models to Ensure Autonomy in Home Health Care
Autonomy is a key principle in health care ethics. Although there has been much debate as to how to define this principle, I there has been overwhelming agreement that autonomy encompasses selfdetennination, self-rule, freedom of the will , and independence. It can be measured by our capacity to critically reflect on, and then accept or change our preferences, desires, values, and ideals. It entails making choices that lead to the quality of life that we desire. Recent trends in health care have moved institutions towards recognizing and supporting patient autonomy, so that patients may achieve the desired quality of life during illness and even to the brink of death. However, the home care situation that is rooted in the relationship between the caregiver and the care receiver, or patient, has less to do with ensuring autonomy and more with fulfilling immediate . needs of the person who is ill or incapacitated. The personal bond between the individuals in this situation tends to suppress issues of justice and autonomy, and this will remain the prevalent scenario until new models are constructed that recognize the needs, and support the autonomy, of the nonprofessional caregiver as well.