Does Covid-19 spell the death of autonomy?

One casualty of the Covid-19 pandemic could be the bioethical principle of autonomy, argues Craig Klugman, of DePaul University, in a provocative blog post at the American Journal of Bioethics. Here are a few excerpts.

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In the case of a response to COVID-19, perhaps our national and personal dysfunction might, in part, be the fault of bioethics’ legendary odyssey to move medicine from paternalism to autonomy. Part of the failure of this country to respond to COVID-19 as well as other nations have can be seen in the lack of a coordinated national response geared toward the common good. It can also be seen in individuals who reject actions that protect their communities: Refusals to wear masks, partying in large crowds, attending huge indoor rallies, going to school or work even when having COVID-19 symptoms are evidence of this view. Under individualism, one has no responsibilities or obligations for the common good because everyone is self-made  (thus stories of being self-made people even when your career starts with over $400 million from a parent). There is no sense of “we are all in this together” or “it takes a village.” Ideal autonomy rests on this image as well, that we are islands unto ourselves and should make rational choices free of outside influences (including effects on family; or taking their needs into account). We regularly teach autonomy as meaning the patient as an individual alone should make the choice….

Is bioethics at least partly at fault? Have we pushed this idea of autonomy and individualism in medicine and other life sciences to the point where a communal and coordinated federal response is “un-American”? Bioethics has been an acolyte of the church of individualism, spreading its gospel around the world.

Bioethics has pushed too far in the direction of the individual and needs to have a turn toward the importance of the community and the common good.

Michael Cook is editor of BioEdge


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