Autonomy

Governing oneself by one's own considered judgement - and the question of how much of that judgement is one's own.

Theme: Ethics and character
Tradition: Western
Term: αὐτονομία · autonomia
Term fixed: 1785

In plain terms

Autonomy is deciding for yourself. The complication is that almost nothing about you was decided by you - your language, your assumptions, your sense of what is normal, and most of what you want.

So the concept cannot mean acting from desires that came from nowhere. What it means in practice is narrower and defensible: that you have examined the commitments you act on, that they are ones you endorse on reflection, and that nobody is deceiving or coercing you.

That is enough to do a great deal of work. It is why consent matters, why manipulation is wrong even when it produces a good outcome, and why a decision made with the relevant facts withheld is not really the person's decision at all - which is a claim with substantial legal consequences.

As a philosopher would put it

Kant's autonomy is the will giving the moral law to itself: acting from a law one legislates rather than from inclination or external command, which is what makes a rational being an end in itself and grounds dignity. Heteronomy - acting from any source outside reason, including one's own desires - is its opposite.

Mill's is a different concept with the same name. Individuality developed through one's own choices, protected by the harm principle, and valuable because it produces flourishing and diversity rather than because it is a condition of morality.

The contemporary literature works with hierarchical accounts - Frankfurt's, where an autonomous desire is one the agent endorses at a higher level - and procedural accounts requiring only that a preference be formed under the right conditions. Feminist critics press the socialisation problem: if preferences are formed by unjust arrangements, endorsement can be part of the damage. Relational autonomy is the response, treating self-governance as something achieved through relationships rather than despite them.

Where you meet it

Nadine Montgomery was a small woman with diabetes, which raised the risk of shoulder dystocia in vaginal delivery. Her obstetrician did not tell her, on the reasoning that most women would opt for a caesarean if told and that this was not in their interest. Her son was born with cerebral palsy.

Until 2015 the governing English standard was Bolam: a doctor was not negligent if their practice accorded with a responsible body of medical opinion, and that covered disclosure as well as treatment.

The Supreme Court in Montgomery v Lanarkshire Health Board replaced it. The test is now whether a reasonable person in the patient's position would attach significance to the risk, or whether the doctor should be aware that this patient would. The judgment states that patients are not passive recipients of care but adults capable of understanding that treatment carries risks. That is autonomy displacing beneficence as the governing principle of an entire professional practice, in a single decision.

What is actually disputed

Whether a preference formed under unjust conditions can be autonomous.

Procedural accounts say yes provided the process was uncoerced and reflective: to say otherwise licenses overriding people's actual choices on the ground that they would want something else if better informed, which is the standard move of every paternalism.

Substantive accounts say no: a person who endorses their own subordination after a lifetime of being shaped to has satisfied every procedural condition and is not self-governing in any sense worth the name.

Neither side has a comfortable position. The procedural view has to accept adaptive preferences as genuine; the substantive view has to specify which contents are compatible with autonomy, which means somebody deciding for others what they may want. The medical, legal and political stakes are large, and the disagreement is the reason consent frameworks look inconsistent across jurisdictions.

Commonly confused with

doing what you want Kant's autonomy is acting from reason rather than inclination, which makes acting on desire the paradigm of heteronomy - the reverse of ordinary usage.
autonomy in politics The Greek sense concerns a community making its own laws. The modern ethical sense concerns individuals, and the transfer is Kant's innovation.

Defined against

Filial piety An ethics grounded in inherited obligation and one grounded in self-legislation give incompatible accounts of where a person's requirements come from

Philosophers

Immanuel Kant Autonomy as self-legislation and the ground of dignity
John Stuart Mill Individuality and the harm principle
Jean-Jacques Rousseau Obedience to a law one prescribes to oneself
Simone de Beauvoir Freedom under conditions one did not choose
Judith Butler The subject as formed by what it did not select

Works

Groundwork of the Metaphysics of Morals Autonomy as self-legislation
On Liberty Individuality and its protection
The Social Contract Freedom as obedience to self-given law
The Second Sex Autonomy under constraint
A Theory of Justice Autonomy built into the design of institutions

Schools

German Idealism Where the concept is formed
Classical Utilitarianism Where it is defended on consequentialist grounds
Communitarianism Where the unencumbered self is criticised
Existentialism Where self-determination is inescapable rather than optional
Ubuntu Philosophy Where personhood is relational rather than self-standing

Related concepts

Dignity 1785 · Free will c. 397 · Agency c. 340 BC · Responsibility c. 340 BC · Authenticity 1927

The Greek word describes a city making its own laws; Kant transfers it to the individual will and makes it the ground of dignity, which is the move that gives the modern concept its force.