{"title":"Why we have duties of autonomy towards marginal agents.","authors":"Anna Hirsch","doi":"10.1007/s11017-023-09623-5","DOIUrl":null,"url":null,"abstract":"<p><p>Patients are usually granted autonomy rights, including the right to consent to or refuse treatment. These rights are commonly attributed to patients if they fulfil certain conditions. For example, a patient must sufficiently understand the information given to them before making a treatment decision. On the one hand, there is a large group of patients who meet these conditions. On the other hand, there is a group that clearly does not meet these conditions, including comatose patients or patients in the late stages of Alzheimer's disease. Then there is a group of patients who fall into the range in between. At the lower end of this range are so-called 'marginal agents,' which include young children and patients in the middle stages of Alzheimer's disease. They also do not meet the typical requirements for autonomy, which is why they are usually granted fewer autonomy rights. However, some of them are capable of 'pre-forms' of autonomy that express what is important to them. These pre-forms differ from mere desires and reflect the identification/authenticity condition of autonomy. They have something in common with autonomous attitudes, choices, and actions - namely, they express the value of autonomy. As I will argue, autonomy is a value worthy of protection and promotion - even in its non-reflexive forms. Against this background, it becomes clear why we have autonomy duties, more precisely positive, autonomy-enabling duties, towards marginal agents and why we should give them as much attention as autonomy duties towards competent patients.</p>","PeriodicalId":46703,"journal":{"name":"Theoretical Medicine and Bioethics","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10564671/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Theoretical Medicine and Bioethics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11017-023-09623-5","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
Patients are usually granted autonomy rights, including the right to consent to or refuse treatment. These rights are commonly attributed to patients if they fulfil certain conditions. For example, a patient must sufficiently understand the information given to them before making a treatment decision. On the one hand, there is a large group of patients who meet these conditions. On the other hand, there is a group that clearly does not meet these conditions, including comatose patients or patients in the late stages of Alzheimer's disease. Then there is a group of patients who fall into the range in between. At the lower end of this range are so-called 'marginal agents,' which include young children and patients in the middle stages of Alzheimer's disease. They also do not meet the typical requirements for autonomy, which is why they are usually granted fewer autonomy rights. However, some of them are capable of 'pre-forms' of autonomy that express what is important to them. These pre-forms differ from mere desires and reflect the identification/authenticity condition of autonomy. They have something in common with autonomous attitudes, choices, and actions - namely, they express the value of autonomy. As I will argue, autonomy is a value worthy of protection and promotion - even in its non-reflexive forms. Against this background, it becomes clear why we have autonomy duties, more precisely positive, autonomy-enabling duties, towards marginal agents and why we should give them as much attention as autonomy duties towards competent patients.
期刊介绍:
AIMS & SCOPE
Theoretical Medicine and Bioethics examines clinical judgment and reasoning, medical concepts such as health and disease, the philosophical basis of medical science, and the philosophical ethics of health care and biomedical research
Theoretical Medicine and Bioethics is an international forum for interdisciplinary studies in the ethics of health care and in the philosophy and methodology of medical practice and biomedical research. Coverage in the philosophy of medicine includes the theoretical examination of clinical judgment and decision making; theories of health promotion and preventive care; the problems of medical language and knowledge acquisition; theory formation in medicine; analysis of the structure and dynamics of medical hypotheses and theories; discussion and clarification of basic medical concepts and issues; medical application of advanced methods in the philosophy of science, and the interplay between medicine and other scientific or social institutions. Coverage of ethics includes both clinical and research ethics, with an emphasis on underlying ethical theory rather than institutional or governmental policy analysis. All philosophical methods and orientations receive equal consideration. The journal pays particular attention to developing new methods and tools for analysis and understanding of the conceptual and ethical presuppositions of the medical sciences and health care processes.
Theoretical Medicine and Bioethics publishes original scholarly articles, occasional special issues on important topics, and book reviews.
Related subjects » Applied Ethics & Social Responsibility – Bioethics – Ethics – Epistemology & Philosophy of Science – Medical Ethics – Medicine – Philosophy – Philosophy of Medicine – Surgery