Progress in medicine: autonomy, oughtonomy and nudging

Area of Science:

• Medical Ethics
• Health Psychology

Background:

• The concept of autonomy in medicine is debated, particularly concerning individuals making unhealthy lifestyle choices despite being informed.
• Absolute autonomy is unattainable, as individuals are influenced by external, heteronomous factors.

Purpose of the Study:

• To propose a new perspective on autonomy in medicine, integrating heteronomy.
• To explore how social conditions and 'nudging' can influence health choices without paternalism.
• To examine the concepts of 'oughtonomy' and nudging in challenging medical autonomy.

Main Methods:

• Conceptual analysis of autonomy and heteronomy in medical decision-making.
• Reflection on 'choice architecture' and 'nudging' strategies.
• Exploration of the neologism 'oughtonomy'.

Main Results:

• Autonomy and heteronomy are intertwined, not opposing forces in human existence.
• The traditional hierarchical opposition of autonomy versus heteronomy in medicine should be questioned.

Conclusions:

• Autonomy is a shared goal in medicine but is always linked with heteronomy.
• Medical progress requires more than just enhancing patient autonomy; it necessitates understanding the complex interplay of influences.