Respect for autonomy

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Autonomy literally means ‘self-rule’. In essence, it refers
to an ability: (1) to reason and think about one’s own
choices; (2) to decide how to act and (3) to act on that
decision, all without hindrance from other people.
Autonomy is more than simply being free to do what
one wants to do. It implies that rational thought is
involved in a decision. While many animals are free
to do what they want, they are not autonomous because
they do not critically evaluate the benefits and risks to
themselves, or others, involved in their decisions.
In respecting a person’s autonomy, we recognize that
they are entitled to make decisions that affect their own
lives. Justification for this principle is most obviously
found in Kantian theory: the idea that people should
be treated not simply as means, but as ends in themselves.
However, support for autonomy can also be
found in those versions of rule-utilitarianism which hold
that the best outcomes arisewhen autonomy is respected.
Often, depending on how young or old, sick or
insane, people may be more or less autonomous. We
may judge that they have the capacity to make all decisions,
some decisions or no decisions. The degree to
which a person is autonomous is central to the concepts
of consent and capacity in medical ethics and law. This
is discussed in Chapter 3.

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