autonomy

Meaning: Autonomy is the sense of acting from one's own choice rather than under outside control. In Erikson's psychosocial theory, toddlers (roughly ages 1 to 3) practice independence through feeding, toileting and choosing what to do. Encouragement builds autonomy, while harsh criticism or overcontrol tends to leave shame and doubt. In self-determination theory, autonomy is one of three basic needs, along with competence and relatedness, and meeting them supports intrinsic motivation. Medical ethics uses a related sense: a patient's right to make informed decisions about their own care.

On the MCAT: A vignette may describe a two-year-old insisting on dressing alone, or parents who punish every mess, and ask you to name the stage and the likely outcome. Another passage may describe rewards or tight control that reduce a person's sense of choice, and ask you to predict a drop in intrinsic motivation (the overjustification effect). Ethics items treat informed consent as respecting autonomy, to be distinguished from beneficence, nonmaleficence and justice.

Common confusion: Students mix up the Erikson stages. Autonomy versus shame and doubt is stage 2, after trust versus mistrust (infancy) and before initiative versus guilt (preschool). Autonomy does not mean a lack of limits. The theory says a child needs supported chances to choose within safe limits.