Autonomy, Respect, and Joint Deliberation

In James F. Childress & Michael Quante (eds.), Thick Autonomy: Personal Autonomy in Ethics and Bioethics. Springer Verlag. pp. 67-85 (2022)
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Abstract

Respecting the autonomy of agents grounds various obligations to others such as non-interference, deference to her authority over self-regarding decisions, limitations on paternalism, and so on. According to a broadly liberal moral sensibility, respecting others in this way implies accepting the valuesValue they autonomously hold even if they are judged problematic, immoral, self-destructive, or otherwise non-ideal. In discussions of such respect, it is generally assumed that persons expressing that respect have no direct bearing on whether the subject of that respect is herself autonomous. However, in many situations, persons interact in a way that helps establish or re-establish the autonomy of one or both of these agents themselves.For example, the would-be paternalist may be a therapist whose professional obligationObligations is to facilitate the process of re-establishing autonomy for vulnerable victims of traumaTrauma. In such scenarios, the usual lines between hardPaternalismhard and softPaternalismsoft paternalism, as well as the standard liberal rejection of the former, do not apply. Still, it would be wrong for the aid workerAid workers to simply impose her views of a decent life on the struggling person. How, then, do we reformulate restrictions on paternalism and other such normative strictures grounded in respect forAutonomyrespect for autonomy in scenarios where the relationshipRelationships between client and aid workerAid workers is itself a crucial part of the process that results in the self-governingSelf-governing agency of the client?This paper explores these issues and argues that such scenarios indicate that conceptions of autonomy must view the self as diachronic as well as socially constituted but also must be sensitive to the ways that autonomy can sometimes be established only with others’ help. In particular, the obligationObligations to remain relatively neutralNeutral toward the content of others’ values in showing respect forPersonsrespect for their autonomy must be reformulated to take into account the way interpersonal dynamics themselves help establish the autonomy with which persons hold the values that they hold. These observations are applied to certain cases of aid and care where such questions are central.

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John Christman
Pennsylvania State University

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