Human beings make decisions about all sorts of things, all of the time. We make decisions each day, differing on the scale of importance and what actually matters. We decide which clothes to put on each morning and what to have for breakfast, as well as deciding to go to war with other nations and to commit actions with very serious consequences. What makes these decisions autonomous, and further more what makes them worthy of protection?
What is autonomy?
An autonomous decision may be described as one that is made freely without undue influence, by a competent person in full knowledge and understanding of the relevant information necessary to make such a decision. According to Beauchamp and Childress ‘Personal autonomy encompasses, at a minimum, self-rule that is free from both controlling interference by others and from certain limitations…’.1 Therefore autonomy and autonomous decisions refer to almost all decisions made by humans on a very regular basis. Which of these very regular decisions deserve to be protected and which may we ignore? Before we tackle which of our autonomous decisions should be respected and followed we must look into why we should have respect for autonomy at all. According to the Kantian theory,2 respect for autonomy flows from the recognition that all persons have unconditional worth, each having the capacity to determine his or her own moral destiny. Kantian ethics argue that autonomy is based on the human capacity to direct one’s life according to rational principles; rationality is the means to autonomy and autonomous people are considered as being ends in themselves in that they have the capacity to determine their own destiny. And as such must be respected. If this is the case then all autonomous decisions made by humans should be respected, regardless of whether they are based on sound moral principles or not. If humans should be respected because of their ability to direct their lives according to rational principles, then if their decisions are rational in their minds, what does it matter if those very same ‘rational’ decisions are not necessarily ‘moral’ ones? I would argue that not very much. John Stewart Mill argued that society should permit individuals to develop according to their own convictions, so long as they do not interfere with a like expression of freedom by others or unjustifiably harm others. Mill’s ‘Harm Principle’ advocated autonomy for all decisions (moral or not) so long as they did not harm or interfere with anyone else’s right to the same. Using this theory it would be ethical to permit a patient to refuse lifesaving medical treatment, even if the treatment was a simple procedure, done often and well. I would argue that allowing someone to refuse a treatment which would save their lives, and was not necessarily a dangerous or uncommon procedure, does not fall within the realms of ‘morality’; yet it is allowed under this theory because humans should be permitted their autonomy so long as they do not harm others-which this patient would not be doing. Mill also claims that the concept of respect for autonomy involves the capacity to think, to decide and act on the basis of such thought, freely and independently. Morals do not seem to come into the equation at all. If decisions are based on free and independent thought should they not be protected regardless of their morality?
There are many conflicting theories and views as to why we should protect autonomous decisions at all, why they so important. But a consensus I have noticed throughout is that all believe that autonomy is something that as human beings we deserve; and as human beings autonomy and free will is a right that is inherent in us. This being the case I would argue that morality (being a subjective construct) shouldn’t come into the question when discussing which decisions are worthy of protection. As humans, all of our decisions should be worthy of protection, because we are humans....
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