The connection between autonomy and the ideal of developing one`s own individual self was adopted in the humanistic psychology of Abraham Maslow and Carl Rogers, who saw the goal of human development as “self-realization” and “becoming a person” respectively. For Maslow and Rogers, the most developed person is the most autonomous, and autonomy is explicitly associated with not depending on others. One argument for greater patient autonomy and its benefits is Dave deBronkart, who believes that in the age of technological advances, patients are able to conduct much of their research on medical topics at home. According to deBronkart, this helps promote better conversations between patients and doctors during hospital visits and ultimately reduces the work of doctors. [44] deBronkart argues that this leads to stronger strengthening of patient care and a more informed health care system. [44] Contrary to this view, technological advances can sometimes be seen as an unfavourable means of promoting patient autonomy. For example, medical self-testing procedures, which have become increasingly common, are supported by Greaney et al. to increase patient autonomy, but may not promote what is best for the patient. In this argument, unlike deBronkart, current perceptions of patient autonomy excessively exaggerate the benefits of individual autonomy and are not the most appropriate way to treat patients. [45] Instead, a broader form of autonomy should be introduced, relational autonomy, which takes into account both the patient`s relatives and the doctor. [45] These different concepts of autonomy can be problematic, as the practicing physician must decide which concept to implement in his or her clinical practice.
[46] Autonomy reflects its original meaning and is often seen as an individual matter. In fact, it develops in our relationships with others. Children are members of the family, school and society in general. Everyone can play a role in children`s ability to make good decisions for themselves. And everyone has a responsibility to question the factors that undermine children`s autonomy. Recognizing the different levels of autonomy at stake in the political sphere as a whole can help clarify what is at stake and avoid one-sided representations of autonomy or the autonomous self. Rainer Forst describes five different concepts of autonomy that can be combined into a multidimensional representation (Forst 2005). The first is moral autonomy, in which an agent can be considered autonomous as long as he “acts on the basis of reasons that take into account all other powers equally” and that are “justified on the basis of reciprocal and universally binding norms” (Forst 2005, 230). Even though it is an interpersonal norm, it is relevant to politics, Forst argues, because it fosters the mutual respect necessary for political freedom. Ethical autonomy refers to the desires of a person in search of the good life, in the context of the person`s values, commitments, relationships and communities.
Legal autonomy is therefore the right not to be constrained to a certain set of values and obligations and is neutral towards them. Political autonomy refers to the right to participate in collective autonomy exercised with other members of the community concerned. After all, social autonomy is about determining whether an agent has the means to be an equal member of that community. Taking into account social autonomy makes it possible to demonstrate the responsibility of the members of the community, to take into account the needs of the other and to evaluate the political and social structures according to their usefulness in promoting the social autonomy of all members. Forst argues that ultimately, “citizens are politically free to the extent that, as defenders of freedom and users of freedom, they are morally, ethically, legally, politically and socially autonomous members of a political community. Rights and freedoms must therefore be justified not only by a concept of autonomy, but by a complex understanding of what it means to be an autonomous person” (Forst 2005, 238). However, the framework of seeing the value of political autonomy in terms of protecting individual decisions has been criticized by those who argue that it is based on an inadequate self-model. In contrast, rationality is an essential characteristic of the self, according to Kant. Thus, a person will be autonomous in terms of decisions and actions if they are guided exclusively by his rationality. Kant is clear that this does not mean that a person is autonomous if he acts rationally to achieve an external goal (for example, to satisfy a desire to eat caviar). To act in this way is simply to act according to what Kant called a “hypothetical imperative” – a rule of the form “If you want to reach X, you have to do Y”. Since actions guided by hypothetical imperatives are motivated by desires, they cannot be carried out autonomously.
Therefore, to act rationally in the sense that the powers of autonomy are justified, a person must act according to a rule that would apply to all rational agents established in a similar way, regardless of their wishes. This requirement is usually expressed in Kant`s “categorical imperative,” one version of which reads: “Act only according to this maxim that you simultaneously want it to become a universal [moral] law” – that is, a law that any rational agent in a similar situation should follow. A person whose actions were guided by the categorical imperative could not lie to gain an advantage, for example, because he does not always want everyone to follow the rule: “Lie if it is to your advantage to do so.” If everyone followed this rule, then no one would trust someone else`s word, and no one, including the person who thinks of lying, would be able to reap the benefits of lying. The emphasis on an autonomous agent`s ability to react to her own reasoning reflects the intuition that someone whose training consisted of a method of indoctrination that deprived her of the ability to question her own attitudes would in fact be governed by her “programmers,” not herself. Thus, even someone whose practical reasoning has been directly manipulated by others would not govern himself with the help of this argument. And so, it seems, it would have no power over the motives that this argument has produced. For Kant, a person is autonomous only if his decisions and actions are not influenced by external factors or insignificant to himself. Thus, a person lacks autonomy or is heteronomous, to the extent that his decisions or actions are influenced by factors such as convention, peer pressure, legal or religious authority, God`s perceived will, or even his own desires. That desires are insignificant to the self is demonstrated by the fact that, unlike the self, they depend on the situation in which one finds oneself (for example, a person who is in the 18th century would be.. A person living in the 21st century would not have – at least not usually – the desire to use a chamber pot). However, a person whose situation and desires change does not become another person. Even if the desires in question are not the product of the social environment, but result from one`s own physiology, they are still insignificant to the person who has them.
A person who loves caviar but doesn`t like lobster would not become another person if they acquired a taste for lobster and lost their flavor for caviar. The aim of the I.Family study is to better understand the interactions between children and their environment, their health behaviour and their individual development. A major concern, therefore, is how children learn to make decisions and how decision-making skills develop as children grow. Especially when thinking about health, people`s interests often conflict with the priorities of powerful commercial players. We want our children to grow up with the skills they need to choose well, defend themselves and live meaningful and rewarding lives.