Aim To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults.Background Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception.

White people have no business playing the blues ever, at all, under any circumstances. What the fuck do white people have to be blue about? Banana Republic ran out of khakis? ~ George Carlin.What, indeed, do white people have to be blue about? The position that Carlin's clever remark sketches for us-that blues performance belongs exclusively to one group of people-can be reformulated as follows:1. In order for a person or group of persons legitimately to sing the blues, they must suffer, or have suffered, in the relevant way. 2. White people do not suffer, or have not suffered, in the relevant way. 3. Therefore, white people "have no business" singing the blues.The argument above captures a few related objections to white people performing the blues. Some blues purists object for largely aesthetic reasons; the blues just doesn't ring true somehow when interpreted and performed by whites. Others suggest that in addition to this aesthetic problem, there are good moral reasons for white musicians to abstain from adopting-and profiting from-the blues style. These objections invoke the idea of ownership, and of these what amounts to cultural theft is the most serious charge. We'll look briefly at a couple of these arguments later. Though there may be reasons in favor of rejecting the first premise of the argument altogether, let's assume for the sake of discussion that there is a certain kind of lived experience that may be vital to blues performance-for both artist and audience. Absent this experience, blues musicians offend at best aesthetically, and at worst, morally. For the most part, it will be the second premise with which I take issue in this chapter; I'm going to argue that at least some white people suffer in the right sort of way and that it is very much their business to sing the blues.