ABSTRACT
The goals of medicine are positive values defining what makes health
care better - to what ends medicine should strive. Such goals form the
basis for determinations of what medical procedures should be offered,
what forms such offers should take, how they should be distributed,
etc. Normative restrictions and principles also come into play in this
and may spark well-known disagreements in bioethics. Although sometimes
marginally questioned, however, traditional goals of releaving suffering
and prolonging life enjoy strong support. However, an increasing trend
is to suggest that these goals should be amended by a further one: the
promotion of autonomy. This suggestion emerges when pondering the introduction
of medical procedures in demand that cannot be shown to clearly promote
traditional medical goals, most notably in assisted reproduction and genetic
testing. Going beyond the idea of respect for autonomy, this suggestion
claims autonomy to be a positive value, whose promotion can by itself motivate
the use of medical procedures. Having emerged in the fields of genetic
counselling and assisted reproduction, these areas will be taken as points
of departure for an exploration of both theoretical and practical issues
raised by this suggestion. Initially, I will argue that its basic idea
is sound. However, it also creates theoretical problems of resolving interpersonal
autonomy-conflicts and determining degrees of autonomy. Practical implications,
such as the issue of whether or not the suggestion leaves any room for
reasons to deny access to medical procedures although they are in demand,
will be dealt with as well.
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