Autonomy is often said to be the dominant ethical principle in
modern bioethics, and it is also important in law. Respect for
autonomy is said to underpin the law of consent, which is
theoretically designed to protect the right of patients to make
decisions based on their own values and for their own reasons. The
notion that consent underpins beneficent and lawful medical
intervention is deeply rooted in the jurisprudence of countries
throughout the world. However, Autonomy, Consent and the Law
challenges the relationship between consent rules and autonomy,
arguing that the very nature of the legal process inhibits its
ability to respect autonomy, specifically in cases where patients
argue that their ability to act autonomously has been reduced or
denied as a result of the withholding of information which they
would have wanted to receive.
Sheila McLean further argues that the bioethical debate about
the true nature of autonomy while rich and challenging has had
little if any impact on the law. Using the alleged distinction
between the individualistic and the relational models of autonomy
as a template, the author proposes that, while it might be assumed
that the version ostensibly preferred by law roughly equivalent to
the individualistic model would be transparently and consistently
applied, in fact courts have vacillated between the two to achieve
policy-based objectives. This is highlighted by examination of four
specific areas of the law which most readily lend themselves to
consideration of the application of the autonomy principle: namely
refusal of life-sustaining treatment and assisted dying,
maternal/foetal issues, genetics and transplantation.
This book will be of great interest to scholars of medical law
and bioethics.
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