Autonomy and Value

Autonomy is an ideal which pervades the rhetoric of modern law, political thought and professional guidance. In these settings, it can often appear to be in tension with other goals which people hold to be important, such as solidarity, security and welfare, especially in conditions of risk or resource scarcity. Should, then, self-determination be simply one more value alongside others, or does it deserve a privileged place in human affairs? Alongside issues about the relative priority of autonomy compared with other values, the evaluative dimension of autonomy itself is also contested. In particular, does respecting someone’s autonomy means allowing them to decide for themselves what is valuable, or is there a threshold of rational or evaluative competence that people must meet in order to be self-governing?

This report examines such connections between autonomy and value. It aims to illuminate these relationships in history, theory and practice, with a focus on autonomy, value and rationality in health and social care settings. The main topics discussed are:

• The nature of autonomy and the justifications for pursuing it
• Whether autonomy requires the possession of evaluative skills or adherence to certain values and norms
• How the effects of mental illness and intellectual disability on individuals’ evaluative and rationality capacities bears upon their autonomy
• The extent to which respect for autonomy requires the state to be neutral about the good life for its citizens

 

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