Agency: Intention and the eco-systemic dimension. Letter of response to Konopasky et al.'s 2025 conceptualisations of agency (AMEE guide No.177)

We commend Konopasky et al. for their 2025 paper concerning agency [Citation1]. Here we offer additional considerations that we hope will be received in the spirit of collegial engagement and shared inquiry. We deeply appreciate their recognition of privilege, oppression, and systemic violence as central to the formation of agency and selfhood, and we find their emphasis on relationality—where the self is co-constructed through interaction—both timely and insightful. Their articulation of positionality within cultural worlds adds important nuance to how we understand the diversity of agency across contexts. Traditional and contemporary perspectives often emphasize the agent’s capacity to choose among possibilities and act with purpose—elements we believe are vital to distinguishing agency from general causality [Citation2]. We feel Konopasky et al.’s definition currently refers to any causal process and misses the distinct importance of decision-making and motivation. While acknowledging some sympathy for a functional characterization of agency, we stress the need to distinguish it from causality. We also see value in more explicitly addressing selfhood alongside agency, as the two are deeply intertwined.