Autonomy and Trust in Bioethics

Autonomy and Trust in Bioethics

Autonomy and Trust in Bioethics

Autonomy and Trust in Bioethics

Synopsis

Onora O'Neill suggests that the conceptions of individual autonomy (so widely relied on in bioethics) are philosophically and ethically inadequate; they undermine rather than support relationships based on trust. Her arguments are illustrated with issues raised by such practices as the use of genetic information by the police, research using human tissues, new reproductive technologies, and media practices for reporting on medicine, science and technology. The study appeals to a wide range of readers in ethics, bioethics and related disciplines.

Excerpt

Autonomy has been a leading idea in philosophical writing on bioethics; trust has been marginal. This strikes me as surprising. Autonomy is usually identified with individual independence, and sometimes leads to ethically dubious or disastrous action. Its ethical credentials are not self-evident. Trust is surely more important, and particularly so for any ethically adequate practice of medicine, science and biotechnology. Trust – or rather loss of trust – is a constant concern in political and popular writing in all three areas. Why then has autonomy landed a starring role in philosophical and ethical writing in bioethics? And why has trust secured no more than a walk-on part?

When I was invited to deliver the Gifford Lectures for 2001 in the University of Edinburgh, I rashly chose the title Autonomy and Trust in Bioethics. I was interested in this divergence between philosophical and popular ethical concerns, and the reasons for its persistence. The topic proved fruitful and more recalcitrant than I had expected. With the help of a thoughtful and encouraging audience in Edinburgh, and of numerous suggestions and comments from friends and colleagues, I have explored a wider terrain than I had originally intended. I have come to think that many recent discussions of both autonomy and of trust are unconvincing, and that this matters greatly for the ways in which we think about ethical questions that arise in the practice of medicine, science and biotechnology. Discussions of autonomy and trust in other areas of life may also be unconvincing; but that is a topic for another occasion.

Although I have been critical of contemporary work in bioethics in this book, my aims are both philosophically and practically . . .

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