Autonomy requires more curiosity and less deference to risk

In ‘Patients, doctors and risk attitudes,’Makins argues for ‘straightforwardly’(Makins 1 p1) extending antipaternalistic views about medical decisionmaking to include deferential considerations of risk attitudes that a patient might endorse. Reflecting on Makins’ important contribution to higher order attitudes in decision theory, we seek to clarify the practical applicability of his argument to specific clinical settings, namely in mental health. We argue that considering low and higher order risk preferences are not only practically difficult, but also potentially ethically fraught and especially so in the provision of mental healthcare. Deferring to risk attitudes potentially mutes a more robust curiosity of patients’ preferences and desires that can promote both autonomy and beneficence but are explicitly relationally grounded. We argue that a relational understanding of autonomy is a much more robust way of thinking about the …