Beyond Autonomy to the Person Coping With Illness

Abstract

In this essay I will examine some of the critique that has been building against autonomy. In doing so I will be concentrating more fully on one of a number of issues I raised in previous work about the limitations of autonomy. In order to do this, I will examine some meanings of autonomy in contemporary bioethics, suggesting that one reason for the growing criticism is that the concept, by sheer variety, has been asked to bear too much weight. Second, I will propose a behavioral basis for our understanding of autonomy that will require rethinking of what characteristics autonomy actually possesses when sick individuals confront the healthcare system and their own altered environments. Third, I will discuss a link between a proper understanding of respect for autonomy and the principle of dominion. Finally, I will try to restructure a concept of autonomy that will be more helpful in an international, interdisciplinary medical ethics by looking at the challenge of dominion over life and environment in the twenty first century.