The Principle of Autonomy
'Those who expect to reap the blessings of freedom must, like men, undergo the fatigue of supporting it.'
Thomas Paine (1737-1809)
In Chapter 1 we saw how a Principle of Autonomy is often appealed to, if only implicitly, in ethical debates. Let us consider another example now.
Without consultation with the individual, a physician has instructed that a middle‐ aged woman who suffers frequent asthma attacks and has severe multiple sclerosis should not be resuscitated if she suffers a cardiac arrest during an asthma attack at the hospital. It is generally agreed that the quality of life of this individual is appalling but since she has not been consulted, what ought the nurses to do if she has a cardiac arrest? (Case study adapted from Beauchamp and Childress.)
In considering this question, a nurse might very well feel that the autonomy of the middle-aged woman has not been respected. What does this mean? Autonomy is, 'the capacity to think, decide, and act on the basis of such thought and decision freely and