Autonomy is relational. A credible choice cannot be made without an appreciation of one’s situation and all the variables. That does not simply mean provision of information and options, because there is more going on in the consultation room, perhaps unexpressed: fear, shame, sadness, anger, doubt.

Time matters. Immediate impulse may not be how you ultimately decide if information shared in a paced, careful, caring, gentle way.

Don’t underestimate the power of written leaflets! Nothing compares to being able to explore in your own time, in your own home.

Being in touch with others who have navigated the same territory themselves is a uniquely therapeutic contribution when having to make choices in circumstances no one would choose.

Autonomy is not solely intellectual. To be vulnerable enough to express fears, to be confident enough to convey personal priorities, to be respected enough to have questions answered truthfully depends on trust in other human beings.

(Deborah Bowman)