Autonomy is a concept often used within International law and conflict studies as a tool to resolve tensions between state and a distinct group wanting to break free from the state. However, autonomy has no real definition within international law. Similarly, autonomy retraction lacks a clear definition and conceptualization, mostly due to it being a rare occurrence. There are five known cases of autonomy retraction. The most recent is India’s revoking of article 370 of the Indian constitution previously granting the region of Jammu and Kashmir a special status of autonomy. This thesis used this case to try and conceptualize autonomy retraction by looking at the historical context of autonomy retraction comparing how the region of Assam, Kosovo, Sudan and Tibet lost their autonomy. Historical context tells us that retraction usually comes from legislative changes and increased nationalistic policy making by central governments. Additionally, the case of Jammu and Kashmir has been examined using an altered version of an existing framework developed by the author Maria Ackrén where she looked at how regional/territorial autonomy is established. The altered version used in the thesis looks at if her framework can be used to see how and why autonomy was retracted in Jammu and Kashmir. Evidently, ideology and growing asymmetric power structures and authoritarian tendencies imposed by the Bharatiya Janata Party in India seem to be at the core to the revocation of article 370. The ultimate goal in this thesis was to conceptualize autonomy retraction and while certain components such as ideology and ethnicity plays a large part as evident in the case of India revoking article 370, further research would be beneficial to identify additional components needed to generalize the concept of autonomy retraction.

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The purpose of this dissertation is to identify how can a focus on the ethical notion of dignity and respect for autonomy help to improve health care for elderly people in Islamic countries. An ethic for aging relies on the principle that the losses of age do not detract from a person’s essential autonomy. Thus, care should be provided without assuming that older people are different from those of other ages. It is possible to determine that ethical values are similar in Islamic cultures as well as, Western countries. But these values are often neglected when people face the need to provide health care to the elderly people. This dissertation provides a critical evaluation of the current view and application of the ethical concepts of dignity and respect for autonomy in Islamic countries including the ethical challenges that elderly people encounter in health care. The study focuses on three parts; first it will provide a general introduction to the bioethics in Islamic countries and its relation to Islamic law (Sharia). The argument is that human dignity does exist in the Islamic religion; however, the application and the functions of the concept in elderly health care are disregarded, due to the cultural understanding and interpretations of the concept. This have led health care providers and societies in Islamic countries to miss the momentum of implementing a strong old-age health and social support system that can maintain elderly people dignity and respect for autonomy, and meet their health care needs. The outcomes mandate further examination towards building greater consciousness of treatment and healing, towards the intellectual and cultural adjustment of health practices. The second part presents the applications of both concepts in Western countries, including their functions and meaning. The arguments characterize the notions of dignity regardless of age. It will identify how dignity is associated with respect for autonomy; thus, dignity and respect for autonomy should be a core value in health care practice. The third part analyses the differences and the deficiencies of the application of both ethical concepts to elderly health care in Islamic countries versus Western countries. The arguments will demonstrate how the application of the ethical principle of respect for autonomy in Islamic countries fails to acknowledge Beauchamp and Childress's principle of respect for autonomy. The analysis will help on understanding the major opportunities for and barriers to successful shift in the Islamic countries in regards to elderly health care and the overall process of aging. The challenge is to make sure that all health care providers have the capabilities to convey appropriate care and treatment with respect and appreciation to the elderly individuals’ dignity. It will suggest adopting several advantageous approaches that arose in the West and worldwide, and modifying it according to Islamic culture to improve elderly health care. The results justifies that the notions of dignity and respect for autonomy can help to improve elderly health care in Islamic countries. Concluding that in Islamic countries, a considerable measure of research, education, and preparation are all needed in the sphere of geriatrics to meet today’s health challenges associated with the increasing of elderly population. A need for adopting a fresh perception on an analytical gerontology and a respected devoted approach that aims to comprehend ageing process and requirements to change for the better. / McAnulty College and Graduate School of Liberal Arts; / Health Care Ethics / PhD; / Dissertation;

by Susan J. Henders. / Thesis (M.Phil.)--Chinese University of Hong Kong. / Bibliography: leaves 215-226. / Acknowledgements / Introduction --- p.1 / Chapter PART I: --- THEORETICAL AND ANALYTICAL CONTEXT / Chapter Chapter 1: --- Evolving Concepts of Territorial Autonomy --- p.12 / Chapter Chapter 2: --- Towards a Dynamic Analytical Framework for Autonomy --- p.30 / Chapter PART II: --- BUILDING AUTONOMY FOR MACAU / Chapter Chapter 3: --- Macau and its Autonomy Process --- p.61 / Chapter Chapter 4: --- Community Identity --- p.87 / Chapter Chapter 5: --- Political Institutions and Political Participation --- p.115 / Chapter Chapter 6: --- The Legal System --- p.138 / Chapter Chapter 7: --- External Support --- p.173 / Chapter Chapter 8: --- Conclusion --- p.209 / Bibliography --- p.215 / Appendix: List of Interviewees --- p.227

This study examines the factors that influence how patients, families, and clinicians make decisions about risk-taking and safety in brain injury rehabilitation. Despite the importance of these decisions, particularly during transitions in care, there is scant literature to help guide these care partners in ethical and clinical decision-making related to risk-taking and safety. This study suggests that there are tensions between rehabilitation and patient safety efforts. Risk-taking lies at the core of brain injury rehabilitation; however, decisions about risk-taking are also influenced by conflicting values, system pressures, and patient abilities. A relational approach to autonomy that addresses patients’ decisional and functional abilities within their social contexts is more nuanced than a liberal individualist approach to autonomy, and provides a better framework for understanding decision-making. Relational autonomy may help clinicians make decisions that better balance risk-taking and safety, decisions that are committed to the principles of respecting autonomy and advancing safety.

This study examines the factors that influence how patients, families, and clinicians make decisions about risk-taking and safety in brain injury rehabilitation. Despite the importance of these decisions, particularly during transitions in care, there is scant literature to help guide these care partners in ethical and clinical decision-making related to risk-taking and safety. This study suggests that there are tensions between rehabilitation and patient safety efforts. Risk-taking lies at the core of brain injury rehabilitation; however, decisions about risk-taking are also influenced by conflicting values, system pressures, and patient abilities. A relational approach to autonomy that addresses patients’ decisional and functional abilities within their social contexts is more nuanced than a liberal individualist approach to autonomy, and provides a better framework for understanding decision-making. Relational autonomy may help clinicians make decisions that better balance risk-taking and safety, decisions that are committed to the principles of respecting autonomy and advancing safety.

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Thesis (Ph. D.)--University of Queensland, 2003. / Includes bibliographical references.

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