Autonomy, Paternalism, and their Medical Relevancy (2014)

Undergraduate: Kendall Nicosia-Rusin

Faculty Advisor: Douglas MacLean
Department: Philosophy

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Autonomy is colloquially understood as a right of self-governance and paternalism is understood to be a violation of autonomy for the benefit of the coerced. These common definitions no longer reflect the origin of the concepts; Kant described autonomy as an essential part of the will of a rational agent. This property, along with its negatively and positively free characteristics, is what binds individuals to moral duties. However, this explanation does not clearly capture concerns regarding violation of autonomy and is far too theoretical to be practical. Instead, I purpose that we see autonomy as a property of a moral agent that allows the agent to rationally set their own ends. Autonomy so defined is not a right but provides the basis for certain rights such as freedom. Paternalism should also be understood independently of autonomy for it can either be a coercive action that interferes with autonomy or a coercive action that interferes with liberty. Applying these concepts to modern medicine and cases of ethical dilemma, I find that physicians are sometimes justified in paternalistic action when it involves a violation of liberty or freedom but are not justified in violating autonomy.