David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 31 (3):127-130 (2005)
Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
Erica K. Salter (2013). Resisting the Siren Call of Individualism in Pediatric Decision-Making and the Role of Relational Interests. Journal of Medicine and Philosophy 39 (1):jht060.
Adalberto de Hoyos, Rodrigo Nava-Diosdado, Jorge Mendez, Sergio Ricco, Ana Serrano, Carmen Flores Cisneros, Carlos Macías-Ojeda, Héctor Cisneros, David Bialostozky, Nelly Altamirano-Bustamante & Myriam Altamirano-Bustamante (2013). Cardiovascular Medicine at Face Value: A Qualitative Pilot Study on Clinical Axiology. Philosophy, Ethics, and Humanities in Medicine 8 (1):3.
A. Ravelingien, J. Braeckman, L. Crevits, D. De Ridder & E. Mortier (2009). 'Cosmetic Neurology' and the Moral Complicity Argument. Neuroethics 2 (3):151-162.
Richard Huxtable (2008). Whatever You Want? Beyond the Patient in Medical Law. Health Care Analysis 16 (3):288-301.
Janet Holt (2008). Nurses' Attitudes to Euthanasia: The Influence of Empirical Studies and Methodological Concerns on Nursing Practice. Nursing Philosophy 9 (4):257-272.
Similar books and articles
James Wilson (2007). Is Respect for Autonomy Defensible? Journal of Medical Ethics 33 (6):353-356.
O. O'Neill (1984). Paternalism and Partial Autonomy. Journal of Medical Ethics 10 (4):173-178.
Onora O'Neill (2002). Autonomy and Trust in Bioethics. Cambridge University Press.
Sheila McLean (2010). Autonomy, Consent and the Law. Routledge-Cavendish.
O. O'Neill (1996). Medical and Scientific Uses of Human Tissue. Journal of Medical Ethics 22 (1):5-7.
Gerald Dworkin (1988). The Theory and Practice of Autonomy. Cambridge University Press.
Charles Foster (2009). Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law. Hart Pub..
Bernard H. Baumrin (1985). The Autonomy of Medical Ethics: Medical Science Vs. Medical Practice. Metaphilosophy 16 (2‐3):93-102.
R. Gillon (1993). Autonomy, Respect for Autonomy and Weakness of Will. Journal of Medical Ethics 19 (4):195-196.
Onora O'Neill (2003). The Inaugural Address: Autonomy: The Emperor's New Clothes. Aristotelian Society Supplementary Volume 77:1 - 21.
Theda Rehbock (2011). Limits of Autonomy in Biomedical Ethics? Conceptual Clarifications. Cambridge Quarterly of Healthcare Ethics 20 (04):524-532.
Jos V. M. Welie (1992). The Medical Exception: Physicians, Euthanasia and the Dutch Criminal Law. Journal of Medicine and Philosophy 17 (4):419-437.
O. O'Neill (2003). Some Limits of Informed Consent. Journal of Medical Ethics 29 (1):4-7.
Gene H. Stollerman (1984). Promoting Patient Autonomy: Looking Back. Theoretical Medicine and Bioethics 5 (1).
M. Parker (1995). Autonomy, Problem-Based Learning, and the Teaching of Medical Ethics. Journal of Medical Ethics 21 (5):305-310.
Added to index2010-08-24
Total downloads53 ( #63,243 of 1,725,426 )
Recent downloads (6 months)47 ( #25,119 of 1,725,426 )
How can I increase my downloads?