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Known links between occupational and environmental stressors and preterm birth [ 89], for example, raise the previously discussed concerns about health disparities and preterm birth, and pose a challenge for maternal autonomy constrained by the tragic exigencies of poverty.
Drawing on the common property framework mentioned earlier, Kremer et al.'s description of the situation suggests that the committee's lack of rule-setting autonomy, constrained by tradition and policy, is a major impediment to the emergence of effective local governance.
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Several empirical studies that explored the impact of consumerism on the patient-provider relationship found the situation to be very complex, in that a continual tension exists between seeking dependency and wanting autonomy, which constrains the patient-provider relationship from moving too far in the direction of consumerism [ 15, 19- 21].
The individual autonomy is being constrained by the fact that the autonomy of each must co-exist with the freedom of all.
Worse off with respect to their health were the women whose work pathway reflected the least autonomy, even within constrained choices: those women who experienced repeated bouts of unemployment while looking for full-time work.
Several of the surveyed physicians felt that their autonomy has been constrained and have elaborated as follows: Feeling of loss of control due to numerous government guidelines & protocols.
Decisions are often made by parents, not the child although there is debate around the role of children, with the model of constrained parental autonomy suggesting that parents make decisions for their children but this autonomy is not absolute[ 21].
Standardized testing has constrained teacher autonomy and creativity, and charter and private schools have competed more aggressively for government funds.
Challenging the assumption of a value conflict involves appreciating how the value of autonomy is shaped and constrained by considerations of psychological and institutional realism and also by evaluative concerns.
Whereas standard modernist accounts of autonomy stress rational decision making and valorize a respect for rights, feminist accounts accent the role of feelings in autonomous lives (Nedelsky 1989; Meyers 1989; Weir 1995) and focus on the way that subordination constrains autonomy (Meyers 1989; Babbitt 1993; Benhabib 1995; Cudd 2006).
A narrow view of autonomy, however, ultimately constrains patient and public decisions in healthcare (Murtagh and Hepworth, 2003).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com