Varied and Principled Understandings of Autonomy in English Law: Justifiable Inconsistency or Blinkered Moralism? [Book Review]

Health Care Analysis 15 (3):235-255 (2007)


Autonomy is a concept that holds much appeal to social and legal philosophers. Within a medical context, it is often argued that it should be afforded supremacy over other concepts and interests. When respect for autonomy merely requires non-intervention, an adult’s right to refuse treatment is held at law to be absolute. This apparently simple statement of principle does not hold true in practice. This is in part because an individual must be found to be competent to make a valid refusal of consent to medical treatment, and capacity to decide is not an absolute concept. But further to this, I argue that there are three relevant understandings of autonomy within our society, and each can demand in differing cases that different courses of action be followed. Judges, perhaps inadvertently, have been able to take advantage of the equivocal nature of the concept to come tacitly to decisions that reflect their own moral judgments of patients or decisions made in particular cases. The result is the inconsistent application of principle. I ask whether this is an unforeseen outcome or if it reflects a wilful disregard for equal treatment in favour of silent moral judgments in legal cases. Whatever the cause, I suggest that once this practice is seen to occur, acceptable justification of it in some cases is difficult to find

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References found in this work

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
Freedom of the Will and the Concept of a Person.Harry Frankfurt - 1971 - Journal of Philosophy 68 (1):5-20.
The Morality of Freedom.Joseph Raz - 1986 - Oxford University Press.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Cambridge University Press.
Autonomy and Trust in Bioethics.Onora O'Neill - 2002 - Cambridge University Press.

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Citations of this work

Evaluating Medico-Legal Decisional Competency Criteria.Demian Whiting - 2015 - Health Care Analysis 23 (2):181-196.
Recent Developments.Cameron Stewart - 2007 - Journal of Bioethical Inquiry 4 (2):341-343.
Recent Developments.Cameron Stewart - 2009 - Journal of Bioethical Inquiry 6 (2):341-343.
Whatever You Want? Beyond the Patient in Medical Law.Richard Huxtable - 2008 - Health Care Analysis 16 (3):288-301.

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