On the Social Function of the "Autonomy Zombie" in Western Bioethics

Stuart Rennie has a characteristically excellent post on the zombie-like existence of autonomy-centric bioethics.  But there's more here than the "cottage industry" of debunking obeisance to autonomy in Western bioethics.

Here's his conclusion:

. . . the horse has been flogged for ages, it is still not dead, and the current zombie-like state of the concept requires an explanation. Why is it, say, that people still find it attractive to say that organ trade between the rich and the poor could be reasonably conceived as a fair and unproblematic trade if conducted between consenting adults? Or that exploitation in international health research is morally acceptable if the 'exploited' party in the transaction adequately consented and might be worse off if he or she did not join a certain study? When a notion seems to be debunked but somehow survives, it is tempting to look past its content and look at the social function it may continue to serve. What does the use of the concept of autonomy 'do' for (some) people when deployed in bioethics arguments? Who gains and who loses when these issues are viewed and defended within frameworks that see individual choice as paramount?

Important questions these, that move well beyond the well-flogged critique to the wider question of why the discourse continues to enjoy such apparent currency in the face of such withering criticisms? Rennie is unquestionably right that a broader functional analysis of the role and utility of the rhetoric might help shed some light on the subject.

Thoughts?

Comments

[Kelly Hills]

Well, I think bioethicists cling to autonomy because there's an undeniable pressure for some kind of measurement criteria, especially from the group(s) that keep pushing for a code of bioethics. This would include a list of how-to's and what to do's and so forth, both in medical ethical situations and in research and writing in general.

I think that the "answer" is that in an environment where bioethics is as measured and scrutinized under scientific guidelines as those in the humanities, there are some people - who have been vocal and in a position to publish and otherwise be heard - who like autonomy because it's easy to measure. We have guidelines that people have agreed upon for what it means to be an autonomous individual, and the notion of autonomy is the same in sciences and humanities. This last bit, in particular, I think is really important - because it's one of the few times where you're going to find sciences-as-a-whole and humanities-as-a-whole speaking the same language.

Add to that that bioethics is a uniquely American field - in that while medical ethics has been a vague sort of medicine for, oh, ever, bioethics and the primacy of autonomy largely comes out of the Seattle God Squad case and crew - and Americans view "freedom" and "autonomy" as synonymous, you get something that's easy to measure, with a lexicon and concept/premise that "all Americans" understand (and has been exported to places where similar American values have ended up - see, for example, the difficulty in pushing autonomy in Asian countries).