Historically the usual approach to medical ethics has been to consider four principles: autonomy (show respect for personal choice), beneficence (consider what is good for the patient), non-maleficence (think about harms), and justice. But today we find that autonomy has become the dominant force. A kind of trump card.
We have seen it played frequently during the recent discussions about medically assisted suicide, haven’t we? Case after emotive case would include, sometimes as the great conclusion, the claim that the ‘victim’ had the right to decide their own destiny. Who were we to dare to challenge their autonomy?
In a slightly different form it has been prominent in the equally emotive transgender discussions too. The very concept of ‘self-identification’ is a powerful assertion of autonomy. Everyone has the right to decide for themselves whether they are a man or woman. How dare you tell someone otherwise based on such irrelevancies as their chromosomal makeup or hormonal balance? Incidental biology is no match for autonomy.
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