Autonomy, Consent, and the “Nonideal” Case

Abstract

According to one influential view, requirements to elicit consent for medical interventions and other interactions gain their rationale from the respect we owe to each other as autonomous, or self-governing, rational agents. Yet, the popular presumption that consent has a central role to play in legitimate intervention extends beyond the domain of cases where autonomous agency is present to cases where far from fully autonomous agents make choices that, as likely as not, are going to be against their own best interest. The question of how we should understand the rationale for eliciting consent in this range of “nonideal” cases is comparatively ill understood. In this paper, I explore the prospects of accounting for consent requirements in such “nonideal” cases by appealing to a set of agency-based interests, including an interest in playing a meaningful part in joint decisions affecting ourselves and others.

Patients as Experts, Participatory Sense-Making, and Relational Autonomy

“…Instead, the guiding idea is that patients contribute to the collaborative process whereby decisions are made. Although they may not possess all the features associated with fully autonomous, self-governing rational agency, they usually do possess features that render them capable of some forms of meaningful communication (Lillehammer 2020). Even though patients do encounter cognitive and affective difficulties, most are still able to appreciate the benefits, risks, and discomforts that can reasonably be expected from various modes of treatment (Cherry 2010, p. 793).…”