Autonomy, discourse, and power: a postmodern reflection on principlism and bioethics

Area of Science:

• Bioethics
• Postmodern Philosophy
• Medical Ethics

Background:

• Critiques of principlism in bioethics are increasing.
• Philosophical underpinnings of bioethical reasoning are being questioned.
• Postmodern perspectives offer alternative frameworks for ethical analysis.

Purpose of the Study:

• To offer a postmodern contribution to the debate on bioethics principlism.
• To analyze the limits of abstract, rationalistic ethical reflection using concepts of power and discourse.
• To examine the principle of autonomy within end-of-life care contexts.

Main Methods:

• Utilizing notions of power and discourse for critical analysis.
• Applying postmodern philosophical concepts.
• Contextualizing the debate through doctoral research on a hospice organization (Karuna Hospice Service).

Main Results:

• The principle of autonomy is central to the discussion.
• The research highlights the limits and superficiality of abstract ethical reasoning.
• A case study of Karuna Hospice Service provides practical insights.

Conclusions:

• The discursive richness of autonomy in hospice care offers valuable insights for bioethics.
• Holistic respect for individuals and active creation of alternatives enrich the understanding of autonomy.
• Reifying autonomy as a principle outside of discourse risks reinforcing biomedical power structures.