Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 212-216).

Thesis (Ph.D.)--University of Iowa, 2006. / Supervisor: David Klemm. Includes bibliographical references (leaves 3441-344).

Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autonomy and informed consent are two interrelated concepts given much prominence in contemporary biomedical discourse. The word autonomy, from the Greek autos (self) and nomos (rule), originally referred to the self-governance of independent Hellenic states, but was extended to individuals during the time of the Enlightenment, most notably through the work of Immanuel Kant and John Stuart Mill. In healthcare, the autonomy model is grounded in the idea of the dignity of persons and the claim people have on each other to privacy, self-direction, the establishment of their own values and life plans based on information and reasoning, and the freedom to act on the results of their contemplation. Autonomy thus finds expression in the ethical and legal requirement of informed consent. Feminists and multiculturalists have however argued that since autonomy rests on the Enlightenment ideals of rationality, objectivity and independence, unconstrained by emotional and spiritual qualities, it serves to isolate the individual and thus fails to rectify the dehumanisation and depersonalisation of modern scientific medical practice. It only serves to exacerbate the problematic power-differential between doctor and patient. Medicine is a unique profession since it operates in a space where religion, morality, metaphysics, science and culture come together. It is a privileged space because health care providers assume responsibility for the care of their patients outside the usual moral space defined by equality and autonomy. Patients necessarily relinquish some of their autonomy and power to experts and autonomy thus cannot account for the moral calling that epitomizes and defines medicine. Recognition of the dependence of patients need not be viewed negatively as a lack of autonomy or incompetence, but could rather reinforce the understanding of our shared human vulnerability and that we are all ultimately patients. There is however no need to abandon the concept of autonomy altogether. A world without autonomy is unconceivable. When we recognise how the concept functions in the modern world as a social construct, we can harness its positive properties to create a new form of identity. We can utilise the possibility of self-stylization embedded in autonomy to fashion ourselves into responsible moral agents that are responsive not only to ourselves, but also to others, whether in our own species or in that of another. Responsible agency depends on mature deliberators that are mindful of the necessary diversity of the moral life and the complex nature of the moral subject. I thus argue that the development of modern individualism should not be rejected altogether, since we cannot return to some pre-modern sense of community, or transcend it altogether in some postmodern deconstruction of the self. We also do not need to search for a different word to supplant the concept of autonomy in moral life. What we rather need is a different attitude of being in the world; an attitude that strives for holism, not only of the self, but also of the moral community. We can only be whole if we acknowledge and embrace our interdependence as social and moral beings, as Homo moralis. / AFRIKAANSE OPSOMMING: Outonomie en ingeligte toestemming is twee nou verwante konsepte wat beide prominensie in moderne bioetiese diskoers verwerf het. Die woord outonomie, van die Grieks autos (self) en nomos (reël), het oorspronklik verwys na die selfbestuur van onafhanklike Griekse state, maar is in die tyd van die Verligting uitgebrei om ook na individue te verwys, grotendeels deur die werk van Immanuel Kant en John Stuart Mill. In medisyne is die outonomie model gegrond op die idee van die waardigheid van die persoon en die beroep wat mense op mekaar het tot privaatheid, selfbepaling, die daarstelling van hulle eie waardesisteem en lewensplan, gebasseer op inligting en redenasie, en die vryheid om op die uitkoms van sulke redenasie te reageer. Outonomie word dus vergestalt in die etiese en wetlike bepaling van ingeligte toestemming. Feministe en multikulturele denkers beweer egter dat, siende outonomie gebasseer is op die Verligting ideale van rasionaliteit, objektiwiteit en onafhanklikheid, sonder die nodige begrensing deur emosionele en spirituele kwaliteite, dit die individu noodsaaklik isoleer en dus nie die dehumanisering en depersonalisering van moderne wetenskaplike mediese praktyk teenwerk nie. As sulks, vererger dit dus die problematiese magsverskil tussen die dokter en pasiënt. Die beroep van medisyne is ‘n unieke professie aangesien dit werksaam is in die sfeer waar geloof, moraliteit, metafisika, wetenskap en kultuur bymekaar kom. Dit is ‘n bevoorregde spasie aangesien gesondheidswerkers verantwoordelikheid vir die sorg van hulle pasiënte aanvaar buite die gewone morele spasie wat deur gelykheid en outonomie gedefinieer word. Pasiënte moet noodgedwonge van hulle outonomie en mag aan deskundiges afstaan en outonomie kan dus nie genoegsaam die morele roeping wat medisyne saamvat en definieer, vasvang nie. Bewustheid van die afhanklikheid van pasiënte hoef egter nie in ‘n negatiewe lig, as gebrek aan outonomie of onbevoegtheid, beskou te word nie, maar moet eerder die begrip van ons gedeelde menslike kwesbaarheid en die wete dat ons almal uiteindelik pasiënte is, versterk. Dit is verder nie nodig om die konsep van outonomie heeltemal te verwerp nie. ‘n Wêreld sonder outonomie is ondenkbaar. Wanneer ons bewus word van hoe die konsep in die moderne wêreld as ‘n sosiale konstruk funksioneer, kan ons die positiewe aspekte daarvan inspan om ‘n nuwe identiteit te bewerkstellig. Ons kan die moontlikheid van self-stilering, ingesluit in outonomie, gebruik om onsself in verantwoordelike morele agente te omskep sodat ons nie slegs teenoor onsself verantwoordelik is nie, maar ook teenoor ander, hetsy in ons eie spesie of in ‘n ander. Verantwoordelike agentskap is afhanklik van volwasse denkers wat gedagtig is aan die noodsaaklike diversiteit van die morele lewe en die komplekse aard van die morele subjek. Ek voer dus aan dat die ontwikkeling van moderne individualisme nie volstrek verwerp moet word nie, siende dat ons nie na ‘n tipe premoderne vorm van gemeenskap kan terugkeer, of dit oortref deur ‘n postmoderne dekonstruksie van die self nie. Ons het verder ook nie ‘n nuwe woord nodig om die konsep van outonomie in die morele lewe mee te vervang nie. Ons het eerder ‘n ander instelling van ons menswees in die wêreld nodig; ‘n instelling wat streef na volkomendheid, nie net van onsself nie, maar ook van die morele gemeenskap. Ons kan slegs volkome wees wanneer ons ons interafhanklikheid as sosiale en morele entiteite, as Homo moralis, erken en aangryp.

Thesis (M.Arch.)--University of Detroit Mercy, 2009. / "24 April 2009." Includes bibliographical references.

O presente trabalho dissertativo tem como objetivo examinar a natureza das relações existentes entre as esferas da moral e do direito no âmbito da filosofia de Kant, a fim de compreender como é sustentada a legitimidade do exercício coercitivo das normas jurídicas, como elemento de justiça, de delimitação dos arbítrios, e pressuposto de uma convivência social racional. O problema que tencionamos investigar diz respeito a saber, em que medida se verifica uma eventual vinculação entre moral e direito nos escritos kantianos. Nessa perspectiva, o primeiro capítulo busca explicitar os conceitos de lei moral, boa vontade e imperativos, bem como as noções de autonomia e heteronomia, elementos esses diretamente implicados na hipótese kantiana da adequação humana necessária às leis prescritas pela razão, no âmbito da liberdade interna. A partir da base conceitual então estabelecida, busca-se, no segundo capítulo, examinar a proposta de um direito natural (racional) como conjunto de princípios a priori da razão pura prática que visam garantir a realização da liberdade na esfera da exterioridade. Para tanto, examina-se o modo através do qual se dá a construção do conceito kantiano de direito e seu respectivo princípio universal, tendo em conta ainda a forma a partir da qual se estabelece a relação entre liberdade (externa) e lei, e o papel da coerção. Uma vez demarcados os dois âmbitos, busca-se, no terceiro capítulo, aprofundar as distinções entre as esferas da interioridade e da exterioridade da liberdade, para então avaliar a hipótese de trabalho que está assentada sobre a possibilidade de uma conexão entre moral e direito na filosofia de Kant. Duas são as principais teses consideradas na investigação: i) a tese da independência e ii) a tese da dependência. A primeira é sustentada pelo grupo de interpretações que afirmam a separação entre moral e direito no pensamento de Kant, assumindo a coerção como elemento característico do direito e a não derivação de seu princípio em relação ao imperativo categórico. A segunda é sustentada pelos interpretes que entendem haver em Kant uma conexão entre moral e direito, baseando-se na desvalorização do elemento coerção e numa acentuação do elemento do dever, pelo que defendem a derivação dos deveres jurídicos da teoria moral kantiana e a derivação do princípio do direito diretamente do princípio da moralidade. Explicitados os elementos constitutivos dessas interpretações, realiza-se, então, ao final, a consideração da possibilidade do vínculo entre moral e direito, e o exame da consistência de uma eventual dependência/derivação dos princípios a priori do direito em relação ao princípio da moralidade, tudo de modo a avaliar em que medida se dá a validade da hipótese assumida e quais pontos sustentam a sua eventual plausibilidade. / Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2015-03-09T16:27:11Z No. of bitstreams: 1 Dissertacao Alvaro Milani Samuel.pdf: 1176002 bytes, checksum: 835ccc97f25e114b4ce2b1f2c6add133 (MD5) / Made available in DSpace on 2015-03-09T16:27:11Z (GMT). No. of bitstreams: 1 Dissertacao Alvaro Milani Samuel.pdf: 1176002 bytes, checksum: 835ccc97f25e114b4ce2b1f2c6add133 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. / This argumentative paper aims to examine the nature of the relationship between the spheres of morality and law in the context of Kant's philosophy in order to understand how the legitimacy of coercive exercise of legal rules is sustained, as justice element of delimitation of wills, and assumption of rational social life. The problem we intend to investigate concerns the extent to which there is a possible link between morality and law in the Kantian writings. In this perspective, the first chapter seeks to clarify the concepts of moral law, goodwill and imperatives as well as the notions of autonomy and heteronomy, these elements directly involved in the Kantian hypothesis of human adaptation necessary laws prescribed by reason, within the internal freedom . From then established conceptual basis, we seek to, in the second chapter, consider the proposal for a natural right (rational) as a set of a priori principles of pure practical reason intended to ensure the attainment of freedom in the sphere of externality. To do so, it examines the way in which it gives the construction of the Kantian concept of law and its respective universal principle, taking into account also the form from which establishes the relationship between freedom (external) and law, and the role of coercion. Once marked the two areas, we seek to, in the third chapter, further distinctions between the spheres of interiority and exteriority of freedom, and then evaluate the working hypothesis that sitteth upon the possibility of a connection between morality and law Kant. There are two main theses considered in research: i) the independence thesis and ii) the theory of dependency. The first is supported by the group of interpretations that affirm the separation between morality and law in Kant's thought, assuming coercion as a characteristic element of the right and not to bypass principle in relation to the categorical imperative. The second is supported by interpreters that understand Kant in a connection between morality and law, based on the devaluation of coercion element and an accentuation of the element of duty, by defending the derivation of the legal duties of Kantian moral theory and the derivation of principle of the right directly from the principle of morality. Explained the elements of these interpretations, takes place then at the end, consideration of the possibility of the link between morality and law, and the examination of the consistency of a possible dependence / derivation of a priori principles of the right to the principle of morality all in order to assess the extent to which gives the validity of the assumed hypothesis and points which support the eventual plausibility.

Uma pesquisa sobre o Princípio Responsabilidade proposto por Hans Jonas é o assunto do presente trabalho. Buscou-se explicitar sobre as peculiaridades da responsabilidade sob uma perspectiva filosófica englobando um novo agir ético frente ao momento tecnológico. A justificativa para a escolha deste tema está na necessidade de ampliação da reflexão sobre o agir humano em relação a natureza, uma vez que este não tem acompanhado a problemática ambiental da atualidade. A questão filosófica que permeia esta dissertação ficou assim descrita: quais os principais fundamentos da ética constituem o Princípio Responsabilidade? Os objetivos centrais e secundários buscam realizar uma pesquisa para compreender os aspectos da ética inseridos no Princípio Responsabilidade propostos por Hans Jonas e pesquisar sobre as características da responsabilidade, sendo estas, autonomia, razão e liberdade respectivamente. Metodologicamente, por se tratar de um estudo teórico, utilizou-se pesquisa bibliográfica. Caracteriza-se também pela tipologia expositiva uma vez que reúne fontes complementares e de apoio para o levantamento e organização dos dados. Pode-se compreender o princípio da responsabilidade como um conceito que está estreitamente ligado à virtude e ao senso de responsabilidade universal. Ademais, é uma força motriz fundamentada em uma ética das relações do homem com o meio ambiente, onde, cada um tem um papel e todos estão interligados. / Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2015-10-07T18:13:59Z No. of bitstreams: 1 Dissertacao Eliana Silvia Balbinot.pdf: 1586671 bytes, checksum: db1c59a7adaede0d1cf8bdfb12fff9cd (MD5) / Made available in DSpace on 2015-10-07T18:13:59Z (GMT). No. of bitstreams: 1 Dissertacao Eliana Silvia Balbinot.pdf: 1586671 bytes, checksum: db1c59a7adaede0d1cf8bdfb12fff9cd (MD5) / A research about the Responsability Principle proposed by Hans Jonas is the subject of the present paper. Explaining about the singularities of responsibility under the philosophical perspective that embraces a new ethical action towards the technological moment is one of its aims. The justification for the choice of this topic is on the necessity of expanding the reflection about human action in relation to nature, since it has not been following the environmental problematics of contemporary world. The philosophical question that permeates this dissertation is as follows: what are the main bases of ethics that constitute the Responsibility Principle? The central and secondary objectives are useful for understanding the ethical aspects intrinsic in the Responsibility Principle proposed by Hans Jonas and for the research about the characteristics of responsibility, as autonomy, reasoning and freedom respectively. Methodologically, for being a theoretical study, a descriptive research including a bibliographical research was used. The research is also characterized by the expositive typology, since it gathers complementary sources for the data resurgence and organization. The Principle of Responsibility can be understood as a concept that is closely related to the virtue and the sense of universal responsibility. Furthermore, it is a driving force based on an ethic of relations of humans with the environment, each having a role. Both of them are interrelated and as a new imperative for the entire human kind, taking into account that the continuous progress cannot be stopped.

Uma pesquisa sobre o Princípio Responsabilidade proposto por Hans Jonas é o assunto do presente trabalho. Buscou-se explicitar sobre as peculiaridades da responsabilidade sob uma perspectiva filosófica englobando um novo agir ético frente ao momento tecnológico. A justificativa para a escolha deste tema está na necessidade de ampliação da reflexão sobre o agir humano em relação a natureza, uma vez que este não tem acompanhado a problemática ambiental da atualidade. A questão filosófica que permeia esta dissertação ficou assim descrita: quais os principais fundamentos da ética constituem o Princípio Responsabilidade? Os objetivos centrais e secundários buscam realizar uma pesquisa para compreender os aspectos da ética inseridos no Princípio Responsabilidade propostos por Hans Jonas e pesquisar sobre as características da responsabilidade, sendo estas, autonomia, razão e liberdade respectivamente. Metodologicamente, por se tratar de um estudo teórico, utilizou-se pesquisa bibliográfica. Caracteriza-se também pela tipologia expositiva uma vez que reúne fontes complementares e de apoio para o levantamento e organização dos dados. Pode-se compreender o princípio da responsabilidade como um conceito que está estreitamente ligado à virtude e ao senso de responsabilidade universal. Ademais, é uma força motriz fundamentada em uma ética das relações do homem com o meio ambiente, onde, cada um tem um papel e todos estão interligados. / A research about the Responsability Principle proposed by Hans Jonas is the subject of the present paper. Explaining about the singularities of responsibility under the philosophical perspective that embraces a new ethical action towards the technological moment is one of its aims. The justification for the choice of this topic is on the necessity of expanding the reflection about human action in relation to nature, since it has not been following the environmental problematics of contemporary world. The philosophical question that permeates this dissertation is as follows: what are the main bases of ethics that constitute the Responsibility Principle? The central and secondary objectives are useful for understanding the ethical aspects intrinsic in the Responsibility Principle proposed by Hans Jonas and for the research about the characteristics of responsibility, as autonomy, reasoning and freedom respectively. Methodologically, for being a theoretical study, a descriptive research including a bibliographical research was used. The research is also characterized by the expositive typology, since it gathers complementary sources for the data resurgence and organization. The Principle of Responsibility can be understood as a concept that is closely related to the virtue and the sense of universal responsibility. Furthermore, it is a driving force based on an ethic of relations of humans with the environment, each having a role. Both of them are interrelated and as a new imperative for the entire human kind, taking into account that the continuous progress cannot be stopped.

Gerald Dworkin's influential account of Personal Autonomy offers the following two conditions for autonomy: (i) Authenticity - the condition that one identify with one's beliefs, desires and values after a process of critical reflection, and (ii) Procedural Independence - the identification in (i) must not be "influenced in ways which make the process of identification in some way alien to the individual" (Dworkin 1989:61). I argue in this thesis that there are cases which fulfil both of Dworkin's conditions, yet are clearly not cases of autonomy. Specifically, I argue that we can best assess the adequacy of Dworkin's account of autonomy through literature, because it provides a unique medium for testing his account on the very terms he sets up for himself - ie. that autonomy apply to, and make sense of, persons leading lives of a certain quality. The examination of two novels - Kazuo Ishiguro's The Remains of the Day and Henry James's The Portrait of a Lady - shows that Dworkin's explanation of identification and critical reflection is inadequate for capturing their role in autonomy and that he does not pay enough attention to the role of external factors in preventing or supporting autonomy. As an alternative, I offer the following two conditions for autonomy: (i) critical reflection of a certain kind - radical reflection, and (ii) the ability to translate the results of (i) into action - competence. The novels demonstrate that both conditions are dependent upon considerations of the content of one's beliefs, desires, values etc. Certain of these will prevent or hinder the achievement of autonomy because of their content, so autonomy must be understood in relation to substantial considerations, rather than in purely formal terms, as Dworkin argues.

O presente trabalho dissertativo tem como objetivo examinar a natureza das relações existentes entre as esferas da moral e do direito no âmbito da filosofia de Kant, a fim de compreender como é sustentada a legitimidade do exercício coercitivo das normas jurídicas, como elemento de justiça, de delimitação dos arbítrios, e pressuposto de uma convivência social racional. O problema que tencionamos investigar diz respeito a saber, em que medida se verifica uma eventual vinculação entre moral e direito nos escritos kantianos. Nessa perspectiva, o primeiro capítulo busca explicitar os conceitos de lei moral, boa vontade e imperativos, bem como as noções de autonomia e heteronomia, elementos esses diretamente implicados na hipótese kantiana da adequação humana necessária às leis prescritas pela razão, no âmbito da liberdade interna. A partir da base conceitual então estabelecida, busca-se, no segundo capítulo, examinar a proposta de um direito natural (racional) como conjunto de princípios a priori da razão pura prática que visam garantir a realização da liberdade na esfera da exterioridade. Para tanto, examina-se o modo através do qual se dá a construção do conceito kantiano de direito e seu respectivo princípio universal, tendo em conta ainda a forma a partir da qual se estabelece a relação entre liberdade (externa) e lei, e o papel da coerção. Uma vez demarcados os dois âmbitos, busca-se, no terceiro capítulo, aprofundar as distinções entre as esferas da interioridade e da exterioridade da liberdade, para então avaliar a hipótese de trabalho que está assentada sobre a possibilidade de uma conexão entre moral e direito na filosofia de Kant. Duas são as principais teses consideradas na investigação: i) a tese da independência e ii) a tese da dependência. A primeira é sustentada pelo grupo de interpretações que afirmam a separação entre moral e direito no pensamento de Kant, assumindo a coerção como elemento característico do direito e a não derivação de seu princípio em relação ao imperativo categórico. A segunda é sustentada pelos interpretes que entendem haver em Kant uma conexão entre moral e direito, baseando-se na desvalorização do elemento coerção e numa acentuação do elemento do dever, pelo que defendem a derivação dos deveres jurídicos da teoria moral kantiana e a derivação do princípio do direito diretamente do princípio da moralidade. Explicitados os elementos constitutivos dessas interpretações, realiza-se, então, ao final, a consideração da possibilidade do vínculo entre moral e direito, e o exame da consistência de uma eventual dependência/derivação dos princípios a priori do direito em relação ao princípio da moralidade, tudo de modo a avaliar em que medida se dá a validade da hipótese assumida e quais pontos sustentam a sua eventual plausibilidade. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. / This argumentative paper aims to examine the nature of the relationship between the spheres of morality and law in the context of Kant's philosophy in order to understand how the legitimacy of coercive exercise of legal rules is sustained, as justice element of delimitation of wills, and assumption of rational social life. The problem we intend to investigate concerns the extent to which there is a possible link between morality and law in the Kantian writings. In this perspective, the first chapter seeks to clarify the concepts of moral law, goodwill and imperatives as well as the notions of autonomy and heteronomy, these elements directly involved in the Kantian hypothesis of human adaptation necessary laws prescribed by reason, within the internal freedom . From then established conceptual basis, we seek to, in the second chapter, consider the proposal for a natural right (rational) as a set of a priori principles of pure practical reason intended to ensure the attainment of freedom in the sphere of externality. To do so, it examines the way in which it gives the construction of the Kantian concept of law and its respective universal principle, taking into account also the form from which establishes the relationship between freedom (external) and law, and the role of coercion. Once marked the two areas, we seek to, in the third chapter, further distinctions between the spheres of interiority and exteriority of freedom, and then evaluate the working hypothesis that sitteth upon the possibility of a connection between morality and law Kant. There are two main theses considered in research: i) the independence thesis and ii) the theory of dependency. The first is supported by the group of interpretations that affirm the separation between morality and law in Kant's thought, assuming coercion as a characteristic element of the right and not to bypass principle in relation to the categorical imperative. The second is supported by interpreters that understand Kant in a connection between morality and law, based on the devaluation of coercion element and an accentuation of the element of duty, by defending the derivation of the legal duties of Kantian moral theory and the derivation of principle of the right directly from the principle of morality. Explained the elements of these interpretations, takes place then at the end, consideration of the possibility of the link between morality and law, and the examination of the consistency of a possible dependence / derivation of a priori principles of the right to the principle of morality all in order to assess the extent to which gives the validity of the assumed hypothesis and points which support the eventual plausibility.

Thesis (MPhil (Philosophy))--University of Stellenbosch, 2009. / ABSTRACT: The European Enlightenment secured man’s freedom from doctrinal thought. Scientific progress and technological innovation flourished in the 18th Century, radically changing the lives of all. Man’s mastery and transformation of his environment was matched by revolutionary political reform, resulting in the dissolution of empire and the transfer of power into the hands of the people. Social transformation saw the city-states of pre-modern man supplanted by a globalized community whose existence grew from time and space distantiation facilitated by the new technologies and the development of symbolic forms. These sweeping social, political and ideological changes of the 18th Century fostered the belief that man’s transformative authority was indeed his to command. Man believed he had a right to self-governance and to autonomous decision-making. Kant described moral autonomy as the freedom men have to show rational accountability for their actions and he saw in men a dignity beyond all price because of this moral autonomy. Personal autonomy is seen as the expression of the free will of individuals and is justifiably constrained by the need to respect the interests and agency of others. The principle of autonomy, in the context of medical practice, was not clearly articulated until the early 20th century. Prior to this, the ethical practice of medicine relied upon the beneficent intentions of the practitioners. The limits to patient autonomy have been delineated largely by issues of social justice based upon the need to share scarce resources fairly among members of society. However, autonomy remains a dominant principle and is most clearly exemplified by the process of informed consent obtained prior to any medical intervention. This thesis provides a conceptual analysis of autonomy in the context of informed consent. Following this, several different clinical scenarios are examined for evidence of justifiable limitations to patient autonomy. Each scenario is examined in the light of different moral theories including deontology, utilitarianism, communitarianism and principlist ethical reasoning. Kantian ethical reasoning is found to be resilient in rejecting any limitation to the autonomy principle whereas each of the other theories allow greater scope for morally-justified curtailment of individual autonomy. The thesis concludes with reflection on post-modern society in which the radicalization of what began with the European Enlightenment sees the transformation of pre-modern society into a global community in which epistemological certainty is no longer available. In this environment, the emerging emphasis on global responsibility requires ethical accountability, not only when individuals secure transactions between one another but also between individuals and unknown communities of men and women of current and future generations. The thesis concludes that patient autonomy is justifiably limited in South African medical practice because of issues related to social justice but that the impact of the new genetic technologies and post-modernity itself may in future set new limits to individual patient autonomy. / OPSOMMING: Die Europese Verligting het die mensdom bevry van verstarde, dogmatiese denke. Wetenskaplike en tegnologiese ontwikkelinge het tydens the 18de Eeu die lewens van almal radikaal verander. Die mens se bemeestering en transformasie van sy omgewing het gepaard gegaan met revolusionêre politieke hervormings wat gelei het tot die ontbinding van tradisionele politieke ryke en die oordrag van mag aan die mens. Sosiale transformasie het veroorsaak dat die politieke ordeninge van voor-moderne mense deur ‘n globale gemeenskap vervang is wat ontstaan het as gevolg van onder meer die ontkoppeling van tyd en plek (Giddens), en wat deur nuwe tegnologiese ontwikkelings en die ontstaan van simboliese vorms moontlik gemaak is. Hierdie uitgebreide ontwikkelinge het die idee laat ontstaan dat niks vir die 18de Eeuse mens onmoontlik is nie. Die mens het geglo dat hy ‘n reg het op self-bestuur en outonome besluite. Kant het die morele outonomie van die mens beskou as sy vryheid om verantwoordlikheid te neem vir sy eie rasioneel-begronde handelinge en verder het hy ‘n besondere waardigheid in die mens geïdentifiseer vanweë sy morele outonomie. Omdat ‘n mens hierdie eienskap besit, beskik hy oor ‘n hoër waardigheid as alle alle ander lewensvorme. Persoonlike outonomie is die uitoefenimg van die vrye wil van die individu en word om geregverdigde redes beperk deur die regte van ander mense. Die beginsel van outonomie met verwysing na mediese etiek het nie voor die begin van die 20ste eeu prominent geword nie. Voor hierdie tyd het mediese etiek staatgemaak op die goeie voorneme van die praktisyn. Die grense van individuele outonomie word nou bepaal deur die noodsaak van sosiale geregtigheid. Al is dit die geval, bly die beginsel van outonomie die belangrikste beginsel in die etiese debat en word meestal gesien as ‘n deel van die proses van ingeligte toestemming. Hierdie tesis verskaf ‘n omvattende ontleding van outonomie met betrekking tot ingeligte toestemming. Daarna word verskillende kliniese gevalle beskryf en ontleed, en verskeie etiese teorieë gebruik om die wyse waarop pasiënt outonomie reverdigbaar ingekort behoort te word, te bespreek. Die teorie van Kant is in staat om enige inkorting van outonomie in alle gevalle the weerstaan. Elkeen van die ander teorieë verskaf redes waarom die outonomie van individuele pasiënte legitiem ingekort mag word. Hierdie werk sluit af met besinning oor die post-moderne gemeenskap wat ‘n globale samelewing moet aanvaar sowel as die ontoereikenheid van enige kenteoretiese sekerheid. Die ontwikkelende verantwoordelikheid vir die totale mensdom in hierdie wêreld veroorsaak dat individue nie meer slegs moet besluit oor die morele verhouding met sy medemens nie, maar ook oor sy verhouding met mense van gemeenskappe wat geskei is in tyd en ruimte, insluitend sy verhouding met die mense van toekomstige generasies. Hierdie werk sluit af met die gevolgtrekking dat pasiënt outonomie regverdigbaar beperk word in die Suid Afrikaanse mediese praktyk deur die noodsaaklikheid van sosiale geregtigheid. Die verwagte impak van nuwe genetiese tegnologieë en die ontwikkeling van ‘n post-moderne gemeenskap mag nuwe beperkings bring vir pasiënt outonomie.