title: Focusing on relationships, not information, respects autonomy during antenatal consultations.
abstract: Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data.
  
  
  CONCLUSIONS
  A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice.
authors.affiliation: Division of Paediatric Emergency Medicine, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.|Clinical Ethics' Unit, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.|CHU Sainte-Justine Research Centre, Montreal, QC, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gaucher
authors.affiliation: Clinical Ethics' Unit, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.|CHU Sainte-Justine Research Centre, Montreal, QC, Canada.|Division of Neonatology, Paediatrics Department, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
authors.forename: Antoine
authors.initials: A
authors.lastname: Payot
mesh_terms: D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics* / Q000523:psychology; D007752:Obstetric Labor, Premature / Q000523:psychology / Q000628:therapy*; D010358:Patient Participation / Q000523:psychology*; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D011209:Power, Psychological; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011295:Prenatal Care / Q000941:ethics* / Q000523:psychology
keywords: Ethics; Guidelines; Neonatology; Prematurity; Prenatal consultation