Autonomy, liberalism and advance care planning

Area of Science:

• Bioethics
• Philosophy of Medicine
• Medical Law

Background:

• Advance directives aim to uphold patient autonomy in end-of-life care decisions, even during states of incompetency.
• Liberal philosophical theory often grounds advance care planning in individual autonomy.
• Several objections challenge the sufficiency of autonomy as the sole basis for advance care planning.

Purpose of the Study:

• To examine four key objections to the concept of autonomy in advance care planning.
• To re-evaluate the philosophical underpinnings of advance care planning.
• To assess the role of liberal autonomy and personal relationships in decision-making.

Main Methods:

• Philosophical analysis of liberal autonomy theory.
• Examination of objections concerning the self, social justice, paternalism, and personal relationships.
• Consideration of empirical research on relationships in advance care planning.

Main Results:

• Liberal autonomy is not inherently flawed regarding the self or social justice.
• Justifiable paternalism can be accommodated within liberal autonomy.
• Liberal autonomy inadequately accounts for the significance of personal relationships in advance care planning.

Conclusions:

• Liberal autonomy is a necessary, but not sufficient, component for advance care planning frameworks.
• Theories emphasizing personal relationships are crucial to supplement liberal autonomy.
• A comprehensive approach requires integrating both individual autonomy and relational values.