
Contents
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Three premises of the autonomy debate Three premises of the autonomy debate
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Value-neutrality and the capacity threshold Value-neutrality and the capacity threshold
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Mental disorder and reasonableness Mental disorder and reasonableness
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Three promising lines of inquiry Three promising lines of inquiry
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Overview of the chapters Overview of the chapters
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Acknowledgements Acknowledgements
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References References
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Introduction: personal autonomy, decisional capacity, and mental disorder
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Published:April 2012
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Three premises of the autonomy debate
Autonomy is a fundamental yet contested concept in both philosophy and our broader intellectual culture. To a great extent, this is due to the widely accepted idea that, by giving precedence to reason over tradition, to individuals over communities, autonomy epitomizes Enlightenment as an overall project and, more precisely, its core philosophical and political doctrine, liberalism.1 This genealogy marks the first point of convergence in the current autonomy debate, an illustration of which is the close association between respect for autonomy, on the one hand, and privacy, on the other. For, in both cases, the ambition is to delimit a sphere of individual action which falls beyond the scope of legitimate state authority.2
This leads us to a second point of convergence in the current debate, according to which personal autonomy is an individual’s right to self-determination, the purpose of which is to protect the exercise of this individual’s capacity for self-determination.3 To simplify, autonomy is an agency concept aiming to define what a person can (legitimately) do. With respect to this second point of convergence, alternative accounts of autonomy could be seen as competing views on the nature of the capacity for self-determination that is worth protecting,4 whereas critiques of autonomy target the right to self-determination which according to them involves a problematic conceptualization of freedom in terms of non-interference. In essence, the charge is that, by focusing on self-determination, autonomy sets out a misleading ideal of free agency as taking place to the exclusion of others. In doing so, it warrants only a thin ‘morality of independence’ to the detriment of richer alternatives, such as that of ‘mutual responsibility’ (Gaylin and Jennings 2003, p. 4).
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