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Importance Of Human Autonomy

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The emphasis on human autonomy correlates to a confusion of the three levels of autonomy as distinguished above: autonomy as a moral principle, and autonomy in its two versions of a methodological principle.13 To start with the latter: epistemological and ontological autonomy are philosophical principles which permeate the whole enterprise of ethics (see below). They include formal requirements, such as rationality, impartiality, freedom from compulsion, and universalizability. As such, they apply to any moral choice, whatever the circumstances, the actors, the interests, the procedures, and so on. However, axiologically interpreted as individual preference satisfaction, respect for autonomy is only one out of a range of moral principles. In health care ethics, autonomy as individual preference satisfaction tends to become a general regulative principle. In effect, individual autonomy seems to have become a soccer game, in which the individual patient not only plays the game, but also writes the rules and referees. In many medical ethics theories, the wolf of individual want-satisfaction comes dressed in the clothes of the universal and impartial sheep of
Kantian autonomy. This threatens to disengage persons from a shared moral and social context, and makes individual preferences the sole basis for morality. No doubt there is reason to speak of a victory of human rights over the paternalism of history. One should not expect, however, that axiological autonomy can do the
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