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Ethics and Bioethics

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Historical and philosophical reflections on patient autonomy.

¹Center for Philosophy and History of Science, 745 Commonwealth Avenue, Room 506, Boston University, Boston, MA 02215, USA. ait@bu.edu

Health Care Analysis : HCA : Journal of Health Philosophy and Policy

|January 25, 2002

Summary

Contemporary medical ethics emphasizes individual rights and patient autonomy. However, Kantian philosophy reveals that self-governance differs from autonomy, limiting its clinical application in modern ethics.

Keywords:

Bioethics and Professional Ethics Philosophical Approach Professional Patient Relationship

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Area of Science:

Bioethics
Medical Ethics
Philosophy of Medicine

Background:

Contemporary American medical ethics emerged during a period of social change emphasizing individual rights.
The concept of patient autonomy developed, influenced by philosophical ideas of self-governance.
Kantian moral philosophy provided an early, ambitious elaboration of autonomy.

Observation:

Kantian ethics, with its universal moral imperative and self-legislated actions, does not fully align with modern pragmatic and pluralistic societies.
Self-governance, as conceptualized by Kant, is distinct from the concept of autonomy used in contemporary ethics.
The limitations of autonomy as a governing principle are highlighted by critiquing Engelhardt's 'principle of permission'.

Findings:

Kantian philosophy's framework for autonomy is insufficient for contemporary medical ethics.
The distinction between self-governance and autonomy is crucial for understanding clinical ethics.
Autonomy's role as a primary principle in medical ethics is challenged.

Implications:

Re-evaluating the philosophical underpinnings of patient autonomy is necessary.
A nuanced understanding of autonomy is required for ethical decision-making in healthcare.
The findings suggest a need for revised ethical frameworks that better accommodate the complexities of modern medical practice.