Why is autonomy valuable

Second, the fact that people are deprived of the authority to make decisions may in part explain why they seem to lack the capacity to do so. Without any incentive to educate themselves about medicine and their medical options, patients may rationally respond by remaining ignorant of the relevant facts because they are unlikely to have the opportunity to act in light of them anyhow.

Third, if patients are not capable of understanding complex information, there is nothing about rights of self-medication that prevents them from consulting with experts, such as pharmacists or physicians, and deferring to their advice as they currently do. Fourth, public officials who are concerned that patients may accidentally poison themselves should reconsider existing policies that prevent patients from accessing and monitoring their medical records and managing their own health choices.

Bateman-House provides three examples of permissible public health interventions: quarantine, water fluoridation, and trans fat bans. She also argues more generally that all population health requires officials to weigh risks and benefits for an entire population. I agree with Bateman-House that it can be permissible to quarantine patients when it is necessary to prevent contagious transmission and when it is the least restrictive alternative. It is for this reason that I also think public officials may permissibly limit access to antibiotics when it is necessary to prevent the contagious transmission of antibiotic-resistant bacteria or require vaccination in some cases.

Water fluoridation is also not objectionably paternalistic. Even though some libertarians object to taxation, which finances the public provision of water, it would not be a further injustice that the water has fluoride in it.

When public officials make it illegal to manufacture or sell foods with trans fats, they coercively prevent people from buying and selling certain foods not because it is harmful to others but in order to benefit those who are being coerced. It is for this reason that, as I have argued elsewhere , paternalistic public health policies such as seatbelt mandates and the prohibition of recreational drugs including methamphetamine are misguided.

For example, physicians are not morally required to break the law for a patient who requests voluntary euthanasia. I agree with this claim, but I also think that physicians are not morally required to comply with unjust laws, including the law that prevents patients from using deadly medicines.

Public users can however freely search the site and view the abstracts and keywords for each book and chapter. Please, subscribe or login to access full text content. To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us. All Rights Reserved. OSO version 0. University Press Scholarship Online. Sign in. Not registered? Sign up. This brings us back, then, to considerations of the liberal project and its potential limitations, where autonomy remains central.

As noted earlier, there are various versions of liberal political philosophy. All of them, however, are committed to a conception of political legitimacy in which political power and authority is justified only if such authority is acceptable to all citizens bound by it see Rawls , — This connects to a broader view of the foundations of value that at least some liberal theorists present as central to that tradition.

That is the claim that values are valid for a person only if those values are or can be reasonably endorsed by the person in question. By extension, principles guiding the operation of institutions of social and political power — what Rawls calls the institutions of the basic structure Rawls , — are legitimate only if they can be endorsed in this way by those subject to them. Dworkin , — Models of autonomy considered above include a condition that mirrors this constraint, in that a person is autonomous relative to some action-guiding norm or value only if, upon critical reflection of that value, she identifies with it, approves of it, or does not feel deeply alienated from it.

Combining this view with the endorsement constraint, liberalism carries the implication that autonomy is respected only when guiding values or principles in a society can be embraced in some way by those governed by them.

This will connect directly to the liberal theory of legitimacy to be discussed below. Perfectionists reject this set of claims. Perfectionism is the view that there are values valid for an individual or a population even when, from the subjective point of view of those agents or groups, that value is not endorsed or accepted Wall , Sumner , 45—80, Hurka , Sher ; see also Perfectionism. In short, it is the view that there are entirely objective values.

While there are perfectionist liberals, this view generally resists the liberal claim that the autonomous acceptance of the central components of political principles is a necessary condition for the legitimacy of those principles.

Moreover, perfectionists question the liberal commitment to neutrality in the formulation and application of political principles Hurka , — Perfectionists specifically target the liberal connection between respect for autonomy and neutrality of political principles Wall , — For many, liberalism rests on the value of individual autonomy, but this reliance either assumes that respect for autonomy is merely one value among others in the liberal view, or autonomy has overriding value.

In either case, however, neutrality is not supported. If autonomy is merely one value among others, for example, then there will clearly be times when state support of those other values will override respect for autonomy paternalistic restrictions imposed to promote citizen safety, for example Sher , 45—, Hurka , —60, Conly On the other hand, autonomy could be seen as an absolute constraint on the promotion of values, or, more plausibly, as a constitutive condition of the validity of all values for a person, as the endorsement constraint implies.

Perfectionists reply, however, that this is itself a controversial value position, one that may not find unqualified general support Hurka , —52, Sher , 58—60, Sumner , —83; cf. Griffin , — To answer these objections, one must turn to consideration of the liberal principle of legitimacy. For the claim that liberals make concerning the limits of state promotion of the good — a limit set by respect for autonomy — depends heavily on their view about the ultimate ground of political power.

Liberalism is generally understood to arise historically out of the social contract tradition of political philosophy and hence rests on the idea of popular sovereignty. The concept of autonomy, then, figures centrally in at least one dominant strand in this tradition, the strand the runs through the work of Kant. The major alternative version of the liberal tradition sees popular sovereignty as basically a collective expression of rational choice and that the principles of the basic institutions of political power are merely instrumental in the maximization of aggregate citizen welfare or, as with Mill, a constitutive element of welfare broadly considered.

But it is the Kantian brand of liberalism that places autonomy of persons at center stage. That is, it is a device in which persons can choose principles to impose upon themselves in a way which is independent of contingencies of social position, race, sex, or conception of the good Rawls , — For under such conditions, no theory of justice which rests on a metaphysically grounded conception of the person could claim full allegiance from members of a population whose deep diversity causes them to disagree about metaphysics itself, as well as about moral frameworks and conceptions of value related to it.

For this reason, Rawls developed a new or further developed understanding of the foundations of his version of liberalism, a political conception Rawls Justice is achieved only when an overlapping consensus among people moved by deeply divergent but reasonable comprehensive moral views can be attained, a consensus in which such citizens can affirm principles of justice from within those comprehensive views.

Political Liberalism shifts the focus from a philosophical conception of justice, formulated abstractly and meant to apply universally, to a practical conception of legitimacy where consensus is reached without pretension of deep metaphysical roots for the principles in question.

The operation of public reason, then, serves as the means by which such a consensus might be established, and hence public discussion and democratic institutions must be seen as a constitutive part of the justification of principles of justice rather than merely a mechanism for the collective determination of the social good. But the role of autonomy in the specification of this picture should not be under- emphasized or the controversies it invites ignored.

For such a consensus counts as legitimate only when achieved under conditions of free and authentic affirmation of shared principles. Only if the citizens see themselves as fully able to reflectively endorse or reject such shared principles, and to do so competently and with adequate information and range of options, can the overlapping political consensus step beyond the purely strategic dynamics of a modus vivendi and ground legitimate institutions of political power.

Indeed, the assumption that all those subject to political authority enjoy the developed capacity to reflectively accept their life path and the values inherent in it invokes a level of idealization that belies the conditions of many victims of past and ongoing oppression.

This virtually ensures that such structural conditions of society as racial domination, profound inequality of power, and patterns of exclusion of groups from equal standing in social space will be assumed away as irrelevant to the question of legitimacy Mills Therefore, social conditions that hamper the equal enjoyment of capacities to reflectively consider and if necessary reject principles of social justice, due, say, to extreme poverty, disability, ongoing injustice and inequality, or the like, restrict the establishment of just principles.

Autonomy, then, insofar as that concept picks out the free reflective choice operating in the establishment of legitimacy, is basic to, and presupposed by, even such non-foundational political conceptions of justice. Critics of political liberalism arise from several quarters. However, among the objections to it that focus on autonomy are those that question whether a political conception of legitimacy that rests on shared values can be sustained without the validity of those values being seen as somehow objective or fundamental, a position that clashes with the purported pluralism of political liberalism.

Otherwise, citizens with deeply conflicting worldviews could not be expected to affirm the value of autonomy except as a mere modus vivendi see, e. A line of response to this worry that could be pursued would be one that claimed that values that amount to autonomy in some conceptualization of that idea are already functional in the social structures and cultural practices of otherwise defensible democratic practices as well as some critical projects that emphasize oppression and domination, as we saw above.

This point raises the issue, to which we now turn, of the connection between autonomy, political liberalism, and democracy. In closing, we should add a word about the implications of political liberalism for the traditional division between liberal justice and democratic theory.

But traditionally, liberal conceptions of justice have viewed democratic mechanisms of collective choice as essential but highly circumscribed by the constitutional provisions that principles of justice support. Individual rights and freedoms, equality before the law, and various privileges and protections associated with citizen autonomy are protected by principles of justice and hence not subject to democratic review, on this approach Gutmann However, liberal conceptions of justice have themselves evolved in some strains at least to include reference to collective discussion and debate public reason among the constitutive conditions of legitimacy.

On this view, legitimacy and justice cannot be established in advance through philosophical construction and argument, as was thought to be the case in natural law traditions in which classical social contract theory flourished and which is inherited in different form in contemporary perfectionist liberal views. Rather, justice amounts to that set of principles that are established in practice and rendered legitimate by the actual support of affected citizens and their representatives in a process of collective discourse and deliberation see e.

Systems of rights and protections private, individual autonomy will necessarily be protected in order to institutionalize frameworks of public deliberation and, more specifically, legislation and constitutional interpretation that render principles of social justice acceptable to all affected in consultation with others Habermas , This view of justice, if at all acceptable, provides an indirect defense of the protection of autonomy and, in particular, conceptualizing autonomy in a way that assumes reflective self- evaluation.

For only if citizen participants in the public discourse that underlies justice are assumed to have and provided the basic resources for having capacities for competent self- reflection, can the public defense and discussion of competing conceptions of justice take place cf. This approach to justice and autonomy, spelled out here in rough and general form, has certainly faced criticism.

These charges are stated here much too generally to give an adequate response in this context. But the challenge remains for any theory of justice which rests on a presumption of the normative centrality of autonomy. To be plausible in a variously pluralistic social setting, one marked by ongoing histories of oppressive practices and institutions, such a view must avoid the twin evils of forcibly imposing a reasonably contested value on resistant citizens, on the one hand, and simply abandoning all normative conceptions of social order in favor of open ended struggle for power on the other.

The view that individuals ought to be treated as, and given the resources to become, autonomous in one of the minimal senses outlined here will, I submit, be a central element in any political view that steers between the Scylla of oppressive forms of perfectionism and the Charybdis of interest-group power politics.

The Concept of Autonomy 1. Autonomy in Moral Philosophy 2. Autonomy in Social and Political Philosophy 3. The Concept of Autonomy In the western tradition, the view that individual autonomy is a basic moral and political value is very much a modern development. Bibliography Alcoff, Linda Martin, Appiah, Kwame Anthony, Arneson, Richard, Jamieson ed. Arpaly, Nomy, Baumann, Holgar, Bell, Daniel, Communitarianism and its Critics , Oxford: Clarendon.

Benhabib, Seyla, Benn, Stanley, Benson, Paul, Taylor ed. Berlin, Isaiah, Berofsky, Bernard, Brighouse, Harry, Brown, Wendy, Bushnell, Dana ed. Butler, Judith, Christiano, Thomas, Christiano, Thomas and John Christman eds. Christman, John, London: Routledge. Christman, John and Joel Anderson eds.

Cochran, David, Coburn, Ben, Autonomy and Liberalism , New York: Routledge. Code, Lorraine, Cohen, Joshua, Conly, Sarah, Cornell, Drucilla, Crittenden, Jack, Crocker, Lawrence, To develop these abilities and attitudes, a person needs the opportunity to consider meaningful alternatives, both opportunities for action and ways of thinking about what matters. By contrast, oppressive social attitudes, rigid social hierarchies and lack of meaningful choices make it harder to develop autonomy and to act on our own interests and values.

The aim of the I. Family study is to better understand the interactions between children and their environment, their health behaviours and their individual development. A key concern, then, is how children learn to make choices and how decision-making skills develop as children become adults. We want our children to grow up with the capacities they need to choose well, to stand up for themselves, and to lead lives that are meaningful and worthwhile.

Parents and educators obviously play an important role, and we need to ask how they can be supported and enabled. How we can help children become media-savvy, and how can companies be led to act more responsibly?