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Autonomy is a vital principle in medical law and ethics. It occupies a prominent place in all medico-legal and ethical debate. But there is a dangerous presumption that it should have the only vote, or at least the casting vote. This book is an assault on that presumption, and an audit of autonomy's extraordinary status. This book surveys the main issues in medical law, noting in relation to each issue the power wielded by autonomy, asking whether that power can be justified, and suggesting how other principles can and should contribute to the law. It concludes that autonomy's status cannot be intellectually or ethically justified, and that positive discrimination in favour of the other balancing principles is urgently needed in order to avoid some sinister results. 'This book is a sustained attack on the hegemony of the idea of autonomy in medical ethics and law. Charles Foster is no respecter of authority, whether of university professors or of law Lords. He grabs his readers by their lapels and shakes sense into them through a combination of no-nonsense rhetoric and subtle argument that is difficult to resist.' Tony Hope, Professor of Medical Ethics, Oxford University 'This book is unlikely to be in pristine state by the time you have finished reading it. Whether that is because you have thrown it in the air in celebration or thrown it across the room in frustration will depend on your perspective. But this book cannot leave you cold. It is a powerful polemic on the dominance of autonomy in medical law, which demands a reaction. Charles Foster sets out a powerful case that academic medical lawyers have elevated autonomy to a status it does not deserve in either ethical or legal terms. In a highly engaging, accessible account, he challenges many of the views which have become orthodox within the academic community. This will be a book which demands and will attract considerable debate.' Jonathan Herring, Exeter College, Oxford University 'This is a learned, lively and thought-provoking discussion of problems central to the courts' approach to ethical issues in medical law. What principles are involved? More significantly, which really underlie and inform the process of seeking justice in difficult cases? Charles Foster persuasively argues, and demonstrates, that respect for autonomy is but one of a number of ethical principles which interact and may conflict. He also addresses the sensitive issue of the extent to which thoughts and factors which go to influence legal decisions may not appear in the judgments.' Adrian Whitfield QC. 'Introducing the Jake La Motta of medical ethics. Foster is an academic street-fighter who has bloodied his hands in the court room. He provides a stinging, relentless, ground attack on the Goliath of medical ethics: the central place of autonomy in liberal medical ethics. This is now the first port of call for those who feel that medical ethics has become autonomized.' Julian Savulescu, Uehiro Chair in Practical Ethics, University of Oxford. "This important book offers a robust challenge to anyone, whether lawyer or 'ethicist', who sees respect for autonomy as the only game in town. It argues eloquently and effectively that, on the one hand, despite the reverence paid to it by judges, in practice the law, even in the context of consent, weaves together a number of moral threads of which autonomy is merely one, in the pursuit of a good decision. It argues on the other hand, that were the day-to-day practice of law to be guided primarily by respect for autonomy, this would be wrong. Foster concludes that whilst, 'any society that does not have laws robustly protecting autonomy is an unsafe and unhappy one', so too would be a society in which too much emphasis was placed on respect for autonomy at the expense of other important moral principles. This is essential reading for anyone interested in the role of autonomy and indeed of medical ethics, in the law." Michael Parker, Professor of Bioethics, University of Oxford
Accountability, autonomy and choice are now the watchwords of education reformers around the globe. This book presents new evidence from the Programme for International Student Assessment (PISA) test on whether students perform better in school systems with such institutional measures in place. It also provides a theoretical framework for considering these reforms and summarizes previous international evidence. The results confirm that various policies promoting accountability, autonomy and choice are strongly associated with higher achievement for students from both disadvantaged and advantaged backgrounds. In particular, choice through public funding for private schools is associated with both higher performance overall and higher equality of opportunity. Providing detailed and rich facets of different forms of accountability, autonomy and choice, this book is unique in its empirically based and internationally oriented treatment of this up-to-date policy topic. It will be of great interest to academics, policy-makers and practitioners, as well as students in education policy and in the economics of education.
The notion that consent based on the concept of autonomy, underpins a good or beneficent medical intervention is deeply rooted in the jurisprudence of most countries throughout the world. Autonomy, Consent and the Law examines these notions in the UK, Australia and the US, and critiques the way in which autonomy and consent are treated in bioethics and law.
This important new book develops a new concept of autonomy. The notion of autonomy has emerged as central to contemporary moral and political philosophy, particularly in the area of applied ethics. professor Dworkin examines the nature and value of autonomy and uses the concept to analyse various practical moral issues such as proxy consent in the medical context, paternalism, and entrapment by law enforcement officials.
Personal autonomy is often lauded as a key value in contemporary Western bioethics, and the claim that there is an important relationship between autonomy and rationality is often treated as an uncontroversial claim in this sphere. Yet, there is also considerable disagreement about how we should cash out the relationship between rationality and autonomy. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether ". . . the reasons for making the choice are rational, irrational, unknown or even non-existent". In this book, I bring recent philosophical work on the nature of rationality to bear on the question of how we should understand autonomy in contemporary bioethics. In doing so, I develop a new framework for thinking about the concept, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in personal autonomy. Furthermore, the account outlined here allows for a deeper understanding of different form of controlling influence, and the relationship between our freedom to act, and our capacity to decide autonomously. I contrast my rationalist with other prominent accounts of autonomy in bioethics, and outline the revisionary implications it has for various practical questions in bioethics in which autonomy is a salient concern, including questions about the nature of informed consent and decision-making capacity.
"At the center of the 'war on women' lies the fact that women in the contemporary United States are facing increased surveillance of their reproductive health. In recent years states have passed a record number of laws restricting abortion and reproductive rights. Physicians continue to sterilize some women against their will, especially those in prison; in other cases, women seeking medical interventions to prevent pregnancies encounter resistance from the medical community. While these trends seem to undermine women's decision-making authority, experts and state actors often defend such policies and actions as actually promoting women's autonomy. In Governed through Choice, Jennifer M. Denbow analyzes recent reproductive measures, such as 'informed consent' to abortion laws and the regulation of sterilization, in order to expose how the notion of autonomy allows for such a striking contradiction in how reproductive policies affect women. Yet, Denbow also offers an understanding of autonomy as critique and transformation of oppressive norms. Denbow shows how developments in reproductive technology, which would seem to increase women's options and autonomy, provide increased opportunities for state management of women's bodies. However, she also argues that reproductive technologies can disrupt oppressive norms about reproduction and gender and ultimately enable social transformation. A critically important analysis, Governed through Choice is a trailblazing look at how the law regulates women's bodies as reproductive sites and what can be done about it"--Unedited summary from paperback book cover.
Argues that laws that enforce what is good for the individual's well-being, or hinder what is bad, are morally justified.
The Natural Selection of Autonomy challenges the deep traditional assumption that autonomy, morality, and moral responsibility are uniquely human characteristics. By examining autonomy on a larger scale in the natural world, it clears away the mysteries associated with autonomy claims and shows what is valuable and adaptive (for humans and other animals) in genuine open alternatives—and how human reason strengthens, rather than creates, autonomous behavior. Drawing on recent research in biology, psychology, and philosophy, The Natural Selection of Autonomy attacks widely shared and deeply held beliefs that have passed from the historical pre-Darwinian philosophical tradition into contemporary thought, and offers a clear look at the evolution of autonomous moral behavior among many species, including—but not limited to—human animals.
This book examines how algorithms in criminal justice, education, housing, elections and beyond affect autonomy, freedom, and democracy. This title is also available as Open Access on Cambridge Core.
This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including self-conception, self-worth, memory, and the imagination.