Autonomy is the personal rule of the self that is free from both controlling interference by others, and from personal limitations that prevent meaningful choice. Autonomous individuals act intentionally, with understanding, and without controlling influence. The word autonomy can have many applications in various areas of study. If we speak of autonomy in the context of the medical profession, matters like; the patients’ rights, informed consent, and taboo subjects such as euthanasia and abortions are brought up. With acts such as the Freedom Of Choice Act, which eliminates restrictions on abortion nationwide, are passed and the government takes tighter control of physicians, physicians will be forced to perform or refer for abortions, provide contraception, offer euthanasia, and other things that might go against that doctors own moral and ethical compass. The right of patients to make decisions about their medical care without their health care provider trying to influence the decision is called patient autonomy.
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Patient autonomy does allow for health care providers to educate the patient, but does not allow the health care provider to make the decision for the patient. In medicine respect for a patient’s personal autonomy is one of many fundamental ethical principles being weighted heavily against beneficence. Autonomy can be defined as the ability of the person to make his or her own decisions. In order to exercise the right of autonomy a patient must first posses the capacity to make decisions. In day-to-day practice doctors might often speak of the competent patient. This means the patient has been educated of all known possible outcomes, is not under the influence of any mind altering substance, and has the mental capacity to understand their decision or the subject of discussion. Users of the health care system have the right to be treated with respect for their autonomy and not feel the powerful influence of the doctor over powering their autonomous decisions.
A patient may only be deemed incompetent by a court of law. If the patient is found incompetent then they lose their right of autonomy until they are deemed competent again. Depending on circumstance, a patient’s right of autonomy may never be regained. If this is the case a guardian or family member may be appointed by the court. The family or court appointed guardian act on behalf of the patient, with only the patient’s best interest in mind. This can be sticky at time. Often their as cases when a family member has had a living will or advanced directives drawn up by lawyers. These documents state the patient’s wishes for treatment if they are unable to communicate or have lost the capacity to communicate their wishes. In some states a family member may override these documents in an emergency situation. The patient has truly lost all aspects of autonomy, although they clearly tried to maintain some aspect of autonmony by having such documents to express the decisions they made while competent. Autonomy in ancient Greek is said to mean self-law. If applied in a philosophical standard it is the capacity of a rational person to make an informed, un-coerced decision. In moral and political philosophy autonomy is often used to determine a person’s moral responsibility for their actions. In court of law a crime maybe said to be premeditated, performed in the heat of passion, or accidental. An individual maybe found insane, meaning they did not and do not have the capacity to understand what they did or the consequences that would occur because of their actions.
A person may also be forced to carry out a crime, in which case the person was not acting autonomously. For instance, a bank robber may take a hostage from the street before going into a bank and force that person to aide or participate in the robbery. That person would not be charged because they are not acting autonomously. Another example in the mass shooting at the Century 21 Theater in Aurora Colorado that killed 12 and injured 58 in July of 2012. The attorneys for James tried to have him deemed criminally insane and have had his case pushed back many times due to his many suicide attempts. The suspect has been undergoing many evaluations and had previously been under the care of a psychiatrist. The court will have to decide if he is fit for trail or if he did or did not have the capacity to understand right from wrong at the time the crime was committed. If he is found not guilty by insanity he will institutionalized. Although the trail is on-going it is a great example of applying autonomy in criminal law. Autonomy is a key concept that has a broad impact on different fields of philosophy. In moral philosophy, autonomy is the ability to impose objective moral law on oneself. Immanuel Kant argued that autonomy is demonstrated by a person who decides on a course of action out of respect for moral duty. This means a person will act morally solely for no other reason but to good because they wanted to without any incentive to do so. If James Holmes is found not to have been able to demonstrate this application of autonomy, he may very well be deemed insane. This would mean he lacks understanding, or lacks the capacity to understand consequence. However, evidence against him suggests otherwise it is up to the court of law to determine his moral autonomy.
The sociological application of autonomy is also used to refer to the self-government of the people. In the United States of America we have an elected government; our democratic system defers that autonomy refers to one’s own self-governance. The Philippine Autonomy Act of 1916 can be examined as one former example of an autonomous jurisdiction. Under this act the United States government provided the Philippine Islands the means for the creation of an autonomous government and enabled the Filipino people to have broader domestic autonomy. Although the Filipino received a sort of domestic autonomy, it reserved the right to maintain certain privileges. One such right is to have the protection of the United States to protect its sovereign rights and interests.
This means that the Philippine Islands is governed by their autonomous rule of law and the United States has no say in their governing process. However, they were placed under the protection of our government to prevent any outside interference with their autonomous government. This act of course granted the Philippine islands independence from the united states as long as is proved to be able to provide and maintain a stable government. This lead to the Commonwealth of the Philippine an extension of the United States which existed from 1935 to 1946. In 1946 this commonwealth ended and the Islands became a autonomous Republic. The word autonomous has many applications but overall no matter what context you apply it to its basic definition stands the same. Autonomy is the act of self-government, whether that means the individual self, sociological self, moral self, or political self. Although Autonomy is a right in some countries, cultures, and religion’s, it is not a right in others. In the United States autonomy is very sacred and applied to the best of ability to many aspects of life.
Some circumstances may deem an individual or group lack the ability to act with moral autonomy or no longer have the capacity to understand consequence. Autonomy is always weighted heavily with beneficence in these circumstances making sure the individual’s self is maintained to the best of the ability of doctors and the court of law.