Autonomy in medical ethics after O'Neill

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)
DOI 10.1136/jme.2004.008292
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
Download options
PhilPapers Archive

Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 22,631
External links
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.

Add more references

Citations of this work BETA

View all 12 citations / Add more citations

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.
O. O'Neill (2003). Some Limits of Informed Consent. Journal of Medical Ethics 29 (1):4-7.

Monthly downloads

Added to index


Total downloads

58 ( #78,801 of 1,938,815 )

Recent downloads (6 months)

2 ( #294,284 of 1,938,815 )

How can I increase my downloads?

My notes
Sign in to use this feature

Start a new thread
There  are no threads in this forum
Nothing in this forum yet.