Independence vs Autonomy

Since college matured my writing, I’ve been revamping old blog posts, but it’s been hard seeing how my disability degeneration has stripped my independence.

Independence is important, but not as much as autonomy. Many able‑bodied people treat independence as the goal for disabled people and often misunderstand it in disability conversations. Autonomy, as control, choice, dignity, and the right to shape your own life, should be the real goal. 

What do disabled people mean by autonomy?

Autonomy is the ability to make informed decisions about your own life. It’s the right to decide what support you need, how you want to live, and what gives your life meaning. It’s not about proving your ability. It’s ownership over your life. It’s the freedom to choose, to say yes or no, to change your mind, and have your decisions respected because you’re a person with dignity, not a managable task, even when support is involved.

Our wet room was recently converted and it happened then. Occupational therapy has one viewpoint. Keep the client safe, even if it removes independence and autonomy. My health sits in a fine balance between doing too much or too little physicality and exercise. I maintain my ability through creating unique “Martyn‑specific” aids and ways of staying independent. These have worked and changed over thirty years, but for OT’s they’re “dangerous” because they’re not officially approved.

Transitions are a problem. When I’m not using custom‑made aids, Hannah lifts me. This isn’t great. I’m ten stone of deadweight that lacks the muscle strength to assist her, which weakens or risks injuring her back.

I understand the OT’s want to secure me, keep me safe, have me transition safely, and keep Hannah healthy. If she injured herself, my overall care would plummet.

Their solution is a hoist. I hate the idea because they look undignified, remove current independence, and increase muscle degeneration that I’m finely balancing through my custom aids.

I’ll need it one day, but not yet. Just like I knew I'd one day need my powerchair. Throughout this wet room conversion, the OT constantly pushed it, despite me repeatedly and respectfully saying no. She didn’t listen. She wanted my health secure at the cost of my independence, which removed my autonomy.

Saying no didn’t matter. I breached their safety guidelines. After months of consultations, meetings, and the two weeks fitting the wet room, it was repeatedly mentioned. I eventually had to say, “If you mention a hoist again, I’ll kick you out of my house. I’ve been clear and you’ve constantly ignored it.” That shouldn’t have been necessary.

My independence was being framed as “pride” and my maintaining “highest achievement,” but one I had to surrender. That wasn’t the case. This is where society misunderstands independence as a moral expectation you do alone rather than a personal preference on what you can choose.

Once you’re judged to have lost independence, autonomy often disappears. People stop listening and assume support means control. Real autonomy does the opposite. It recognises that everyone needs help through different moments in life and still gives the person dignity. It’s about having the right support at the right time, guided by the individual’s decisions, not managed for them.

Autonomy isn’t isolation. It’s relational. It sits within community, responsibility, and how our choices impact others. It’s not absolute freedom. It’s freedom within the expectation that decisions are informed, rational, and uncoerced. It’s the belief that vulnerability doesn’t remove your right to choose. It’s the principle that people should be treated as ends in themselves, not as means to an outcome. It’s the understanding that autonomy must be protected by safeguards, not overridden by them.

This is where autonomy overlaps with equality and equity. Equality gives everyone equal provision. Equity gives what is needed to have the same chance. Autonomy sits firmly with equity. It recognises individuality through the variety of support, tools, or adjustments to gives the same agency as everyone else. 

It also links to accessibility and usability where autonomy assures practices are usable. You can offer support, but if it removes choice, control, or dignity, it isn’t usable support. It’s a barrier dressed up as help.

This is why disabled people fight for accessible housing, personal assistants, adaptive technology, inclusive healthcare, and social care that listens. These increase autonomy without lessening independence.

College discussed this last year by highlighting autonomy as everything listed above and its importance in society, morals, and laws, like how assisted suicide and end‑of‑life care are currently debated. It showed how deeply people value control, dignity, the right to shape personal stories, and how disabled people understand this more than most. 

We know what it feels like to fight for agency over our own lives. Decisions get made for us. Choices get filtered. Risks get removed. Voices get softened. Autonomy gets replaced with protection, even when it harms us.

I see it in online disability groups. Disabled people don’t need to be independent to live full, meaningful, dignified lives. We need autonomy, choice, control, support that respects us, systems that listen, and a society that understands the difference. We need to be trusted to know what matters in our own lives, to take reasonable risks, and say what we want, not what others think we should want.

Independence is a preference. Autonomy is a right. A moment when our voice and choice make a difference.