Abstract

The presentation made by Professor Lie addresses a topic that is crucial not only in the domain of medical ethics, but also in the ethics of the various professions: the autonomy of the subject with which the professions are concerned. In addition, the presentation succeeded in enhancing creativity, particularly with its final proposal: if the demand for autonomy contains a wish to guarantee the patient’s independence and initiative — i.e., the power to decide for himself or herself — there is a possibility that the proper way to foster this power would be to reject an ethics based on autonomy.Can we really dispense with all reference to the principle of autonomy? And would such a decision be liberating? Drawing on the work of Foucault, Professor Lie points in a suggestive direction while at the same time recognizing the need for solid theoretical work before we can find any viable alternative. While I await with great interest the developments that will lead to new models in the physician-patient relationship, my task at present is to respond to the practical and intellectual challenge by suggesting that instead of ignoring the principle of autonomy, we would do better to refine its subtleties, with a view to surpassing the limitations that we tend to run up against when putting it into practice.