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

2 comments:

  1. Bravo, Alex. My own journey of this is through reading something on 'knowing'. The author contend that we can't have any knowledge or recognition of reality except through the 'Other' and pre-cognition exposure to the world through our context. In other words, our knowledge of reality is inescapably from our acknowledgment by the Other and our context.

    And euthanasia and all the talk about 'individual rights' set me thinking through what the author wrote.

    In case u are curious, the author is Calvin Schrag. His article titled 'Traces of Rationality: Acknowledgment, Recognition, and Repetition' in 'The Evolution of Rationality' edited by F. LeRon Shults.

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  2. Josh, remember our discussion on epistemology which we say knowing includes actions in "reading (taking in facts/experience)", "faith" and "community". Interesting to note Schrag's proposition in that light.

    Steven Sim

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