Will Covid-19 dethrone ‘autonomy’ as the dominant principle of bioethics?

What will bioethics look like after Covid-19? The experience of lockdowns, social isolation, fear of an invisible enemy, deference to experts, and dependence could change perceptions of how we approach ethical dilemmas.

Ruth Chadwick, co-editor of the journal Bioethics, muses in a recent editorial on the vehemence of public opinion about lockdown. “A survey undertaken by the UK think tank Demos found that 12% of mask wearers said they ‘hate’ those who do not wear face coverings, while 14% of lockdown respecters expressed the same emotion towards rule breakers.”

What does this suggest about the principles of bioethics? “Hatred is several steps beyond social disapproval. It suggests that there may be something more here than concerns about the free rider problem, or even worries about direct threats to one’s personal safety, if people are being regarded as ‘bad’ regardless of the relative riskiness of their behaviour in particular situations.”

Perhaps more reflection on solidarity is called for and less on autonomy. “Perhaps most striking, however, in the light of the Demos findings, is the question of what the conditions for the possibility of social solidarity might be,” she writes, “and the implications for the applicability and usefulness of the principle of solidarity in bioethics.”

Chadwick is the latest of a number of bioethicists – from very diverse schools of thought – who are questioning the dominant paradigm of autonomy. Carter Snead argues that autonomy presents “an incomplete and false vision of human identity and flourishing” which defines a human being “as an atomized and solitary will”. Laura Williamson contended recently that autonomy is of little use in ethical discussions about substance abusers. And Craig Klugman pointed out that “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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