Autonomy, Discourse, and Power: A Postmodern Reflection on Principlism and Bioethics
Journal of Medicine and Philosophy. 1998 Oct; 23(5): 516-532.
In recent years there has been an increasing critique of the philosophy based reasoning in bioethics which is known as principlism. This article seeks to make a postmodern contribution to this emerging debate by using notions of power and discourse to highlight the limits and superficiality of this abstract, rationalistic mode of reflection. The focus of the discussion will be on the principle of autonomy. Recent doctoral research on a hospice organization (Karuna Hospice Service) will be used to contextualize the debate to end-of-life ethical dilemmas. The conclusion will be reached that the discursive richness of this organization's notion of autonomy or choice, which incorporates a holistic respect for the individual and the active creation of alternatives, can provide important insights to our understanding of autonomy in bioethics. The concern is raised that if autonomy is reified as a principle outside of the context of discourse, it may only complement the hegemonic power of biomedicine.
Alternatives; Autonomy; Bioethics; Biomedical Technologies; Buddhist Ethics; Decision Making; Discrimination; Ethicists; Ethics; Home Care; Hospices; Hospitals; Life; Medicine; Philosophy; Physicians; Postmodernism; Principle-Based Ethics; Power; Research; Sociology; Sociology of Medicine; Terminal Care; Terminally Ill;
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