This might sound familiar: You’re facing an important decision about how to treat a health condition. Your doctor recommends one approach. Your cousin posts on Instagram about possible side effects. A podcast you follow questions whether the treatment is even necessary. And a quick Google search pulls up everything from credible research to alarmist conspiracy theories.

You’re not alone in this confusion.

In our modern communications environment – where everyone has a microphone and algorithms determine what we see – making informed health decisions is harder than ever.

We Say Autonomy Is Essential in Health Care. But Are We Really Supporting It?

Autonomy has long been considered a foundational principle in medicine and public health. It’s about giving people the freedom – and responsibility – to make their own decisions about their health.

Real-world complexities can make that freedom feel conditional or uneven though. Faced with overwhelming and often contradictory health information, people are left to sort through it on their own – a difficult task for anyone.

It’s no wonder that so many feel stuck, skeptical, or simply disengaged.

Autonomy, According to Psychology—Not Social Media

One theory that may help us think differently about autonomy is Self-Determination Theory (SDT). Developed by psychologists Edward Deci and Richard Ryan, SDT identifies three psychological needs that are essential for motivation and well-being: competence, relatedness, and – yes – autonomy.

Autonomy in this context though is not just about having choices. It’s about being supported in making choices that are meaningful and self-directed.

Health communication, when done well, should foster autonomy in exactly this way. It should give people the information, context, and confidence they need to make health decisions that feel right for them.

Too often, though, our messaging is perceived as trying to drive compliance rather than build trust. Health communicators may sometimes rely on fear-based messaging, one-size-fits-all PSAs, oversimplifying complex issues, or presenting information in ways that are overly technical and difficult to understand.

While fear may drive short-term behavior, research has consistently shown that without a sense of efficacy, fear-based messages backfire. They shut people down instead of drawing them in.

And they don’t build trust for the long term.

Moreover, we often assume that if people just had the facts, they’d make the “right” decision. But we know that facts alone aren’t enough. In today’s digital ecosystem, people need help making sense of facts – especially considering all the information people have access to now-a-days.

What Supporting Autonomy Should Look Like & How Artificial Intelligence Can Help

If we want to support autonomy – not just say we support it – we need to change how we communicate.

That means:

• Offering health information that is unbiased, transparent, timely, and tailored
• Using empathetic messaging that invites participation, not just compliance
• Elevating community voices who can build trust and foster cultural relevance
• Designing content that meets people where they are – cognitively, emotionally, and technologically

And yes, we believe that artificial intelligence (AI) has a role to play here too.

Used responsibly, AI tools can help tailor health messages in real time, adjust based on individual needs, and provide supportive guidance.

But the emphasis has to be on responsibly. If these systems aren’t co-designed with the communities they aim to serve – and built with transparency – they risk repeating the same mistakes at scale.

That’s why I’m especially encouraged by NORC at the University of Chicago’s pioneering initiative, Health Communication AI (HCAI). HCAI applies the principles of Self-Determination Theory to explore how AI can improve today’s health communication landscape through personalized, empathetic, and unbiased messaging – supporting more informed decision-making, engaging diverse audiences, and enhancing the overall impact of public health efforts.

For example, together with the Science Translation Foundation, we are designing a program to support personalized, accessible health communication for neurodiverse young adults. What makes this effort unique is not just the technology, but the process: young people are involved from the very beginning, co-designing how the tool works and how it communicates.

This work is autonomy in action – technology that doesn’t just inform but supports people in making decisions that reflect their own needs and lived experiences.

Redefining the Road Ahead

Health autonomy is talked about now more than ever before.

But it’s not just a trendy term. It’s the cornerstone of effective public health. If we want people to make choices that are good for them, they need more than just facts – they need support, trust, and a communication ecosystem that values their role in the process.

Particularly when informed by theories like SDT that define autonomy in this way, AI-driven health communication approaches can be a bridge, not a barrier: translating health guidance into plain language, tailoring messages to individual communication styles, and offering clarity and empathy when it’s needed most – scaling health communication like never before.

So to the communicators, clinicians, and policymakers reading this: What are you doing to support real autonomy in your work? And what could you be doing differently?

Because in the end, more content isn’t the answer. More clarity, more trust, and more compassion is.

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About the Authors:

Amelia Burke-Garcia, PhD, is a health communicator and director of the Center for Health Communication Science at NORC at the University of Chicago.

 

 

William T. Gallo, PhD, is an economist and health policy expert and the executive director of the Science Translation Foundation.