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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