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A non-ideal authenticity-based conceptualization of personal autonomy
KTH, School of Architecture and the Built Environment (ABE), Philosophy and History, Philosophy.ORCID iD: 0000-0003-1456-4352
2018 (English)In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Article in journal (Refereed) Published
Abstract [en]

Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp and Childress’s theory, this article develops a non-ideal authenticity-based conceptualization of personal autonomy. Factors that indicate inauthentic decision-making are explicated, and the full concept is defended from three expected objections. The theory is then tested on a paradigm case which has concerned theorists and practitioners for some time, namely the possible inauthenticity of anorexia nervosa patients’ decision-making. It is concluded that the theory seems to be fruitful in analyses of the degree of autonomy of patients’ decision-making, and that it succeeds in providing reliable action-guidance in practical contexts.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Autonomy, Authenticity, Anorexia nervosa, Healthcare, Bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
URN: urn:nbn:se:kth:diva-244298DOI: 10.1007/s11019-018-9879-1ISI: 000482898400006PubMedID: 30456734Scopus ID: 2-s2.0-85056868482OAI: oai:DiVA.org:kth-244298DiVA, id: diva2:1289612
Funder
Swedish Research Council, 2014–4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014–4024
Note

QC 20190218

Available from: 2019-02-18 Created: 2019-02-18 Last updated: 2022-06-26Bibliographically approved
In thesis
1. Authenticity in Bioethics: Bridging the Gap between Theory and Practice
Open this publication in new window or tab >>Authenticity in Bioethics: Bridging the Gap between Theory and Practice
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. It is argued that (in-)authenticity is difficult to observe in others. The second article offers a solution to this difficulty in one theory of authenticity. It is proposed that under certain circumstances, it is morally justified to judge that the desires underlying a person's decisions are inauthentic. The third article incorporates this proposition into an already established theory of personal autonomy. It is argued that the resulting conceptualization of autonomy is fruitful for action-guidance in authenticity-related problems in healthcare. The fourth article collects nine cases of possible authenticity-related problems in healthcare. The theory developed in the third article is applied to the problems, when this is allowed by the case-description, to provide guidance with regard to them. It is argued that there is not one universal authenticity-related problem but many different problems, and that there is thus likely not one universal solution to such problems but various particular solutions.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2019. p. 147
Series
Theses in philosophy from the Royal Institute of Technology, ISSN 1650-8831 ; 62
Keywords
Authenticity, autonomy, decision-making, healthcare, paternalism, informed consent, bioethics
National Category
Ethics
Research subject
Philosophy
Identifiers
urn:nbn:se:kth:diva-244301 (URN)978-91-7873-124-4 (ISBN)
Public defence
2019-06-10, Kollegiesalen, Brinellvägen 8, Stockholm, 13:00 (English)
Opponent
Supervisors
Funder
Swedish Research Council, 2014–4024Forte, Swedish Research Council for Health, Working Life and Welfare, 2014–4024
Available from: 2019-03-21 Created: 2019-02-18 Last updated: 2022-06-26Bibliographically approved

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Ahlin Marceta, Jesper

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