Autonomy Ethical Issues Notes

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Consent - the Ethical dimensions Ethics and Autonomy • By emphasising the principle of autonomy o We've moved from a "doctor knows best" attitude o To one where the rights of the patient are recognised • The importance of autonomy o Cardozo J:  Every human being of adult years and sound mind has a right to determine what shall be done with his own body • And a surgeon who performs an operation without his patient's consent commits and assault o Much as the medical profession might believe a procedure to be in a patient's best interests  Or may even be morally required for a patient • It is still seen as morally wrong to force that treatment on the patient • Kennedy: if the beliefs and values of the patient, though incomprehensible to some, have formed the basis of the patient's decisions about his life o There is a strong argument to suggest that the doctor should respect and give effect to a patient's decision based on them o To argue otherwise would effectively rob that patient of a right to his personality -  something for more serious and destructive than anything that could follow from the patient's decision to the proposed treatment Should autonomy be absolute?

• Are all autonomous decisions worthy of respect? o Keown: The capacity to choose brings with it the responsibility of making not just any old choice, but choices which promote human flourishing  Many choices from different lifestyles do allow human flourishing • But it is difficult to see why patently immoral choices, clearly inconsistent with human well-being, merit any respect • The exercise of autonomy merits respect only when it is exercised in accordance with a framework of sound moral values. o Herring: Supporters would reply that there is a difficulty in identifying what decisions are "consistent with human flourishing"  Some people might say that train spotting is inconsistent, but it is an activity greatly valued by some  But then, Keown has a point - is a life spent reading porn one deserving of respect?

• Letting people live their lives as they want can lead to disastrous results o Me: Society cannot function if everyone just does what they want  There have to be certain agreed principles which people have for society to function • Making an autonomous decision to reject these means that we need sanctions etc. to keep society functional

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