Abstract
The challenge in maintaining patient autonomy regarding medical decision-making and confidentiality lies not only in control over information transferred to and regarding patients, but in the ambiguity of autonomy itself. post-modernity is characterized by the recognition of not just numerous accounts of autonomy, but by the inability in a principled fashion to select one as canonical. Autonomy is understood as a good, a right-making condition, and an element of human flourishing. In each case, it can have a different content, depending in part on whether it is given a nomological or a volitional construal. Different accounts of autonomy can lead to strikingly different understandings of appropriate behavior, including the argument that one ought on behalf of autonomy to liberate individuals from the sense of autonomy they themselves affirm. In the face of competing accounts of moral probity, autonomy in a secular morality and bioethics must by default be understood in terms of the permission of patients, which makes space for numerous moral accounts and different communal construals of free choice, which in turn will legitimate different practices of informing patients and maintaining confidentiality.
Similar content being viewed by others
References
Appelbaum, P.S. (1993) Must We Forgo Informed Consent to Control Health Care Costs? A Response to Mark A. Hall. Milbank Quarterly 71, 669-676.
Engelhardt, Jr., H.T. (1996) The Foundations of Bioethics, 2nd edn. New York: Oxford University Press.
Engelhardt, Jr., H.T. (2000) The Foundations of Christian Bioethics. Lisse: Swets & Zeitlinger.
Frankel, J. (1994) Medical Malpractice Law and Health Care Cost Containment: Lessons for Reformers from the Clash of Cultures. Yale Law Journal 103, 1297-1331.
Frankfurt, H. (1971) Freedom of the Will and the Concept of a Person. Journal of Philosophy 68, 5-20.
Frankfurt, H. (1972) Coercion and Moral Responsibility. In T. Honderich (Ed.), Essays on Freedom of Action (pp. 72-85). London: Routledge.
Frankfurt, H. and Locke, D. (1975) Three Concepts of Free Action. Proceedings of the Aristotelian Society, suppl. Vol. 49, pp. 95-125.
Hall, M. (1993) Informed Consent to Rationing Decisions. Milbank Quarterly 71, 645-668.
Hanson, N. (1961) Patterns of Discovery. Cambridge: Cambridge University Press.
Korsgaard, C.M. (1996) Creating the Kingdom of Ends. New York: Cambridge University Press.
Kultgen, J. (1995) Autonomy and Intervention. New York: Oxford University Press.
Lyotard, J.-F. (1984) The Postmodern Condition, trans. G. Bennington and B. Massumi. Manchester: Manchester University Press.
MacIntyre, A. (1981) After Virtue. Notre Dame, IN: University of Notre Dame Press.
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1982) Making Health Care Decisions, 3 vols. Washington, DC: US Government Printing Office.
Schneewind, J.B. (1998) The Invention of Autonomy. New York: Cambridge University Press.
Thalberg, I. (1978) Motivational Disturbances and Free Will. In H.T. Engelhardt, Jr. and S.F. Spicker (Eds.), Mental Health: Philosophical Perspectives (pp. 201-220). Dordrecht: Reidel.
Vattimo, G. (1988) The End of Modernity. Baltimore: Johns Hopkins University Press.
White, B.C. (1994) Competence to Consent. Washington, DC: Georgetown University Press.
Whitbeck, C. (1978) Towards an Understanding of Motivational Disturbance and Freedom of Action. In H.T. Engelhardt, Jr. and S.F. Spicker (Eds.), Mental Health: Philosophical Perspectives (pp. 221-231). Dordrecht: Reidel.
Wildes, K.W. (2000) Moral Acquaintances. Notre Dame, IN: University of Notre Dame Press.
Wolf, S. (1990) Freedom Within Reason. New York: Oxford University Press.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Engelhardt, H.T. The Many Faces of Autonomy. Health Care Analysis 9, 283–297 (2001). https://doi.org/10.1023/A:1012949730926
Issue Date:
DOI: https://doi.org/10.1023/A:1012949730926