title: The many faces of autonomy.
abstract: What does autonomy mean from a moral point of view? Throughout Western history, autonomy has had no less than four different meanings. The first is political: the capacity of old cities and modern states to give themselves their own laws. The second is metaphysical, and was introduced by Kant in the second half of the 18th century. In this meaning, autonomy is understood as an intrinsic characteristic of all rational beings. Opposed to this is the legal meaning, in which actions are called autonomous when performed with due information and competency and without coercion. This last meaning, the most frequently used in bioethics, is primarily legal instead of moral. Is there a proper moral meaning of the word autonomy? If so, this would be a fourth meaning. Acts can only be called moral when they are postconventional (using the terminology coined by Lawrence Kohlberg), inner-directed (as expressed by David Riesman), and responsible (according to Hannah Arendt). Such acts are autonomous in this new, fourth, and to my mind, the only one proper, moral meaning. The goal of ethics cannot be other than forming human beings capable of making autonomous and responsible decisions, and doing so because they think this is their duty and not because of any other nonmoral motivation, like comfort, convenience, or satisfaction. The goal of ethics is to promote postconventional and mature human beings. This was what Socrates tried to do with the young people of Athens. And it is also the objective of every course of ethics and of any process of training.
authors.affiliation: Department of Public Health and History of Science, Complutense University of Madrid, 28040 Madrid, Spain. dgracia@fcs.es
authors.forename: Diego
authors.initials: D
authors.lastname: Gracia
mesh_terms: D026688:Bioethical Issues; D003068:Coercion; D006801:Humans; D007258:Informed Consent; D008678:Metaphysics; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics; D011057:Politics