Respect for Autonomy has been a mainstay of medical ethics since its enshrinement as one of the four principles of biomedical ethics by Beauchamp and Childress’ in the late 1970s. This paper traces the development of this modern concept from Antiquity to the present day, paying attention to its Enlightenment origins in Kant and Rousseau. The rapid C20th developments of bioethics and RFA are then considered in the context of the post-war period and American socio-political thought. The validity and utility (...) of the RFA are discussed in light of this philosophical-historical account. It is concluded that it is not necessary to embrace an ethic of autonomy in order to guard patients from coercion or paternalism, and that, on the contrary, the dominance of autonomy threatens to undermine those very things which have helped doctors come to view and respect their patients as persons. (shrink)

El artículo reconstruye tres estratos de un concepto de lo social que puede encontrarse en la filosofía práctica de Immanuel Kant sin recurrir a sus textos de antropología e historia. Para ello se especifican las nociones de coexistencia humana y coacción recíproca universal que describe en su Metafísica de las costumbres, con el fin de indicar que con ellas no cabe referirse a una sociedad, sino a la forma de una. Posteriormente se reconstruyen algunas coordenadas de la “comunidad ética” presentes (...) en La religión..., para argumentar, por una parte, que aquí puede hablarse de una sociedad como tal, y por otra, que esta puede conformar un puente entre la forma de la sociedad jurídica y la formación ética de las personas, i.e., entre el uso externo de la libertad y su uso interno, al socializar máximas morales y abrigar estas una peculiar normatividad intrínseca. (shrink)

In this article, we discuss Greek and Roman conceptions of liberty. The supposedly ‘neo-Roman’ view of liberty as non-domination is really derived from negative Greek models, we argue, while Roman authors devised an alternative understanding of liberty that rested on the equality of legal rights. In this ‘paleo-Roman’ model, as long as the law was the same for all, you were free; whether or not you participated in making the law was not a constitutive feature of liberty. In essence, this (...) Roman theory was a theory of freedom as the rule of law and the guarantee of equal rights, especially due process rights. For this Roman concept of ‘legal liberty,’ as we call it, political participation was neither necessary nor sufficient. Theorized by Cicero and historicized by Livy, the Roman understanding of freedom flourished in early-modern times, proving important to paradigmatic republican authors such as Machiavelli and Rousseau as well as to Hobbes, whose work we discuss as a helpful point of comparison. (shrink)

Rousseau’s political project consists in ensuring that the citizens of the social contract, in uniting with each other, preserve their ability to self-legislate, or be autonomous. For this to work, however, members of the social contract would need to feel intrinsically linked to the political whole. This essay investigates what that feeling might be and how it can be grown. I argue that Rousseau develops a model of the energy or character of the being capable of autonomy, capable of experiencing (...) themselves as part of the whole. That energy is a pathos of vigour, a strong sentiment and way of being that I develop from Rousseau’s educational precepts in Émile, which makes the citizen feel free and robust in dependence and boundedness. Autonomy, then, comes from the active exercise of oneself, physically and mentally, in an environment bounded by things, and this results in a sentiment of vigour, a vitality that produces confidence and poise, which then entices further activity. (shrink)