Abstract

In my dissertation I examine the concept of personal autonomy and what it means to respect its exercise within the context of healthcare. In doing so I work to provide a model for doing medical ethics that is educational rather than exhortative, whose focus is helping healthcare providers become more sophisticated in their understanding of what their practices and beliefs and values mean. Specific to the matter of autonomy, I argue that most adults should be regarded as autonomous, that HCPs should respect patients' exercise of autonomy even when HCPs do not think it is in the patient's best interest to do so, and that in order to respect patients' autonomy HCPs must work to establish relationships and shared networks of understanding with their patients. ;A major challenge for my view involves establishing that most adult patients should be thought of as self-governing and that their decisions are indeed autonomous. Most of us do not create our own language or generate our own core values. We acquire the vast majority of our character traits, habits, and beliefs subconsciously. And of course there are untold and powerful influences that affect virtually every decision we make and action we perform. Moreover, the fact that people frequently make bad and stupid decisions that are harmful to themselves and inconsiderate of others challenges both the primacy I wish to attribute to respecting patients' exercise of autonomy as well as the validity of the designation "primarily self-regarding." ;In setting forth my position and responding to challenges, I work to counter an all too familiar conception of medical ethics as an abstract analysis best carried out by experts to be then handed down to HCPs in the form of rules or guidelines. I am interested in providing a model for doing medical ethics that can be understood as a process for enriching HCPs' understanding of themselves and their practices