Thursday, December 18, 2008

Is there such thing as a true autonomy?

Sze Zeng's post on Anything goes as long as no harm on others set me thinking about True or Total Autonomy.

True or total autonomy
  • Takes no account of needs of others, nor of the individual’s need for others. It is based solely on the needs of the individual making the decision
    • Nothing about living with others
    • Life is lived in communities; family, workplace, religious, academic
    • Making decision without others – like planning a garden with regard to soil, climate etc
  • Takes no account of the autonomy of those individuals whose help may be needed to achieve that decision
    • Take no account of those who have to carry out the order
  • Concept of total autonomy does not take into account the realities of life
    • No such thing as total autonomous decision making
    • All my decision impinges on someone else
    • One cannot have everything
    • Society do not owe you anything
    • Concept based on an illusion. Why such we base so much of our decision making based on a delusion.
    • Autonomy recent after the human rights movement
  • Concept of total autonomy in a medical situation depends heavily upon the help of the physician, without actually acknowledging it
    • There is a contractual relationship between patient and physician
    • Paternalism
    • Physician becomes a servant
    • “these are my rights and you better deliver it”
    • Total autonomy prevent the doctor from providing the best possible care
  • Concept of total autonomy in medical situation do not take into account the realities of clinical practice
    • It is not realistic for patient to be involved in every aspect of his/her care
    • Hospital will come to a stand-still if it is totally subjected to the patient's demands

I do not think there is such a thing as true or total autonomy. It is just wistful thinking

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