Abstract
My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Jonsen AR, Toulmin S. The Abuse of Casuistry: A History of Moral Reasoning. Los Angeles: University of California Press, 1988.
Levine RJ. Ethics and Regulation of Clinical Research. New Haven, CT: Yale University Press, 1986.
Beauchamp TL, Childress JF. Principles of Biomedical Ethics, Third Edition. New York: Oxford University Press, 1989.
Engelhardt HT. The Foundations of Bioethics. New York: Oxford University Press, 1986.
Cassell EJ. The function of medicine: Restoring autonomy to the patient. Hastings Center Report 1977; 6: 214–222.
Engelhardt HT. Human well-being and medicine: Some basic value-judgments in the biomedical sciences. In: Callahan D, Engelhardt HT, eds., Science, Ethics and Medicine. Hastings-on-Hudson, New York: The Hastings Center, 1976: 120–139.
Illich I. Medical Nemesis: The Expropriation of Health. New York: Bantam, 1977.
Descartes R. Meditationes De Prima Philosophia. Paris: Vrin, 1978. Translated in: Haldane ES, Ross GRT, eds. The Philosophical Works of Descartes, Vol. 1. New York: Cambridge University Press, 1981: 131–200.
Kant I. Beantwortung der Frage: Was Ist Aufklärung? In: Werkausgabe, Vol. XII. Frankfurt/Main: Suhrkamp, 1977: 53–61. Transl. Beck LW as What is enlightenment? In: Kant I. Foundations of the Metaphysics of Morals. Indianapolis: Bobbs-Merrill, 1976: 85–92.
Kant I. Werkausgabe, Vol. XI. Frankfurt/Main: Suhrkamp, 1977.
Heidegger M. Brief über den Humanismus. In: Wegmarken. Frankfut/Main: Klostermann, 1978: 311–360. Transl. Letter on Humanism. In: Basic Writings. New York: Harper & Row, 1979: 189–242.
Krakauer E. On medicine and politics. The Yale J of Biol Medicine 1992; 3: 243–250.
Lifton RJ. The Nazi Doctors. New York: Basic, 1986.
Müller-Hill B. Murderous Science. New York: Oxford University Press, 1988.
Proctor RN. Racial Hygiene: Medicine Under the Nazis. Cambridge, Mass.: Harvard University Press, 1988.
Kevles DJ. In the Name of Eugenics. Los Angeles: University of California Press, 1985.
Jones JH. Bad Blood: The Tuskegee Syphilis Experiment. New York: Free Press, 1981.
Kant I. Die Metaphysik der Sitten. Frankfurt/Main: Suhrkamp, 1977. Transl. Gregor M. as The Doctrine of Virtue. Philadelphia: University of Pennsylvania Press, 1980.
Kant I. Grundlegung zur Metaphysik der Sitten. In Werkausgabe Vol. VII. Frankfurt/Main: Suhrkamp, 1977: 9–102. Transl. Beck LW as Foundations of the Metaphysics of Morals. Indianapolis: Bobbs-Merrill, 1976.
Kant I. Anthropologie in pragnatischer Hinsicht. Frankfurt/Main: Suhrkamp, 1977. Transl. Dowdell VL as Anthropology from a Pragmatic Point of View. Carbondale: University of Illinois Press, 1978.
Heidegger M. Die Frage nach der Technik. In: Vorträge und Aufsätze. Pfullingen, Germany: Neske, 1978: 9–40. Transl. The Question Concerning Technology. In: The Question Concerning Technology. New York: Harper & Row, 1977: 3–35.
Heidegger M. Die Zeit des Weltbildes. In: Holzwege. Frankfurt/Main: Klostermann, 1980: 73–110. Transl. The Age of the World Picture. In: The Question Concerning Technology. New York: Harper & Row, 1977: 115–154.
Foucault M. Le retour de la morale. Les Nouvelles 1984 June 28: 16.
Foucault M. Naissance de la clinique. Paris: PUF, 1983. Transl. Sheridan Smith AM as The Birth of the Clinic. New York: Vintage, 1975.
Heidegger M. Wissenschaft und Besinnung. In: Vorträge und Aufsätze. Pfullingen, Germany: Neske, 1978: 41–66. Transl. Science and Reflection. In: The Question Concerning Technology. New York: Harper & Row, 1977: 155–182.
Kant I. Der Streit der Fakultäten. In Werkausgabe, Vol. XI. Frankfurt/Main: Suhrkamp, 1977: 260–393. Transl. Gregor M as The Conflict of the Faculties. New York: Abaris, 1979.
Derrida J. Altérités: Jacques Derrida et Pierre Jean Laberrière. Paris: Osiris, 1986.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Krakauer, E.L. Prescriptions: Autonomy, Humanism and the Purpose of Health Technology. Theor Med Bioeth 19, 525–545 (1998). https://doi.org/10.1023/A:1009999909072
Issue Date:
DOI: https://doi.org/10.1023/A:1009999909072