Paternalism, autonomy and consent

This module critically focuses on three interconnected concepts—autonomy, paternalism and consent—that are of key importance for ethics, political philosophy and applied philosophy, and that are the focus of wide discussion in moral psychology and philosophy of mind.   In the first couple of weeks be begin by looking at the notion of liberty (some senses of “autonomy”, as we shall see, are pretty much the same as “liberty”) and then raise some puzzles about how we should best characterize “personal autonomy”.  Weeks 3-5 focus on different ways that autonomy can be undermined, with or without the knowledge of the agent herself.  In weeks 6 and 7 we turn to a distinctive kind of restriction on autonomy: paternalistic actions (or policies) restrict agents’ autonomy for the agents’ own interests.  Paternalism is a particular problem in medicine because doctors may know a lot more about a patient’s best medical interests than the patient herself.  Traditionally this has underpinned a practice of medical deception.   In week 8 we turn to informed consent as a “solution” to the problem of medical paternalism: informed consent requirements oblige doctors to disclose information about risks and benefits of treatments (and non-treatment), so that patients can make their own decisions.  In biomedical ethics this is standardly justified by appeal to a principle of: respect for autonomy.  In week 9 we end up with an interesting contemporary development in discussions of paternalism.  Libertarians in political philosophy are people who give a very high value to individual liberty and autonomy.  Libertarians are typically opposed to state policies which seek to protect individuals’ best interests.  Is there scope for a “libertarian paternalism”?  The final week is an essay outline presentation and discussion session.

Topics

 

1.      Liberty and autonomy – why are they important?

2.      Personal  autonomy: how and when are we autonomous?

3.      Autonomy undermined 1: addiction

4.      Autonomy undermined 2: oppressive socialization

5.      Autonomy undermined 3: advertising

6.      Paternalism: overriding autonomy for the agent’s own good

7.      Medical paternalism and medical deception

8.      Informed consent

9.      Nudge? Libertarian paternalism

10.  ESSAY OUTLINE PRESENTATION WEEK

 

A detailed handbook with reading lists, study questions and suggested essay questions, will be provided at the first session.