Autonomy and Trust in Bioethics (Gifford Lectures, 2001) by Onora O'Neill

By Onora O'Neill

Onora O'Neill means that the conceptions of person autonomy (so broadly trusted in bioethics) are philosophically and ethically insufficient; they undermine instead of aid relationships in line with belief. Her arguments are illustrated with matters raised by way of such practices because the use of genetic info via the police, examine utilizing human tissues, new reproductive applied sciences, and media practices for reporting on drugs, technology and know-how. The learn appeals to a variety of readers in ethics, bioethics and similar disciplines.

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Dignity, integrity, individuality, independence, responsibility and self-knowledge . . self-assertion . . critical reflection . . freedom from obligation . . absence of external causation . .    Michael Power, The Audit Explosion, Demos,  and The Audit Society: Rituals of Verification, Oxford University Press, . Gerald Dworkin, The Theory and Practice of Autonomy, Cambridge University Press, , . , The Inner Citadel: Essays on Individual Autonomy, Oxford University Press, , –, esp.

Supposedly the ideals of trust and autonomy have been reshaped and are now compatible.  VARIETIES OF AUTONOMY To judge whether autonomy and trust as now construed are indeed compatible, we need a rather clearer view of autonomy. This is not easily acquired. Gerald Dworkin began a book on autonomy by listing about a dozen distinct understandings of the notion. He suggested that it has been variously equated with Liberty (positive or negative) . . dignity, integrity, individuality, independence, responsibility and self-knowledge .

May parents determine whether teenage children – so-called mature minors – should be allowed contraception? When should parents be allowed to decide whether one child should undergo tests or investigation for the benefit of a sibling? Is parental consent sufficient to allow blood tests, or genetic tests, or ‘donating’ bone marrow for the benefit of a brother or sister? Could parental consent suffice for the ‘donation’ of a kidney?  Equally difficult questions arise for many adults. Under what conditions may adults be treated in defiance of their currently expressed wishes (for example, during mental disturbance) or at variance with their previously expressed wishes (for example, those expressed in ‘living wills’ or prior declarations)?

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